Patient had a crown placed within the past six months. She developed a sinus tract on the buccal. Conservative dual access made to address the mesial and distal canals. Pus mixed with blood flowed out of the access Calcium hydroxide placed in the interim. Patient returned with her sinus tract healed, Obturated the tooth after 2 months seeing radiographic improvement of the PAL. Took CBCT to rule out a second distal canal, and obturated with GP and Kerr EWT sealer. Closed access with composite.


The stepwise management from dual access to obturation and closing with composite appears well executed. The radiographic improvement after 2 months and the decision to use CBCT for further evaluation showcase a comprehensive approach to resolving the issue.
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