Wednesday, January 28, 2026
Periodontal ProJR: 52 year old woman with toothache
Began with upper jaw pain few days ago, insidious but noticed acute exacerbation recently
Diagnosis was apical pulpitis with periodontal inflammation:
There's an arrow in the above xray at the root of the right first molar for which an RCT cleaning with insertion of gutta percha was planned RCT Gutta Parcha
Post RCT x-ray
The pain continued and finally a gum boil appeared
In between there was some integrative medicine as evidenced by the image of the repertory above that appeared to have sorted the pain although later when the gum boil appeared it was difficult to figure out what had really reduced the pain? Did the pain come down because of the intra oral sinus which is a modern pathophysiologic label for a gum boil?
More in general about gum boil here: https://en.wikipedia.org/wiki/Intraoral_dental_sinus
"Gum boil is aka Intraoral dental sinus aka parulis. The etiology of intraoral dental sinuses is primarily linked to periapical abscesses, which develop when bacterial infections from the root canal system extend into periapical tissues." Unquote from above link
Gum boil day 1
Gum boil day 2
Gum boil incised and second session of RCT done after a week
Post second RCT x-ray: Post operative day 1:
More periodontal PaJR links from the periodontal project:
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