1. Diagnosis and Treatment Planning 52 yr old male who has had perio eval after seeing his general dentist. The periodontist want to know if #18 can be retreated or should it be extracted? Courtesy Dr. Randy Hedrick and ROOTS

2. Radiographs

3. Examination and Testing Fluctuant, boggy swelling on #18-19 buccal area for several months that usually drains in the morning, no pain, some soreness until after it drains. Cold: #20 no response, #21-23 normal response Perio: #18 8+mm, with purulence #20 8-10mm, with purulence #20 8-10mm, with purulence #21-23 <3mm #21-23 <3mm No percussion or bite sensitivity Bridge #18-20 has CL I mobility #18 previous endo tx with multiple posts/pins

4. More Radiographs

5. Diagnosis Malignant Lymphoma, diffuse large B-cell type

6. Comments #17-22 were extracted, Chemo and radiation therapy Wife 2yrs later “You would never think that a dentist could save your life but you did it for us.” 5/2/06 No recurrence, annual checks with oncologist “Please continue to show my case others so they can learn from it. I think that is just awesome for you to continue to show it!”