Diagnostic radiographic findings and symptom-free teeth

The determination of whether a symptom-free tooth has pulpal and periapical disease relies heavily on radiographic findings and pulp tests. A case of a symptom-free upper left first molar is presented. The radiographic evidence of pathological changes associated with the endo-antral syndrome coupled with diffuse pulpal calcifications facilitated the diagnosis of chronic pulpal periapical disease. Non-surgical root canal therapy resulted in periapical healing as shown on a follow-up radiograph.