veterinarydentistry's posterous

My Response

And the response

Hi John,
    There is bone loss in the furcation secondary to the increase in plaque retention due to the fracture.  No concrete evidence of endodontic disease is present periapically however that doesn't mean that it is subltle or not evident just yet. The root of the first molar adjacent to the distal root gives the impression of lucency but I can't appreciate it when compared to the mesial aspect of the apex.   Additional views might confirm it.  I mention the previous only for educational purposes.  Regardless of the radiographic appearance if the pulp chamber is exposed the tooth should be extracted or have root canal therapy and may result in resolution of the epistaxis.  I would do at minimal a BMBT prior to surgery to rule out the remote chance of clotting defects.  Generally with signs like this I will extract unless the owner wants to save the tooth.  Once the root canal is performed the lesion will heal.   This tooth can but does not characteristically cause nasal bleeding, however.  Neoplasia should still be number on on the rule out list.  Hope this helps.