Fractured Fourth Premolar with Pulp Exposure

This question came in today

My name is John Rosado and I am a dental technician from Lake Emma Animal Hospital.  I am emailing you on behalf of Dr. David Blake and Dr. John Dee for your evaluation of the following dental radiographs.  The patient is a 12 year old chow mix presenting with unilateral epistaxis of the right nostril for 2 weeks.  Dr. Blake wished to ask if tooth number 108 has a root abscess forming on the distal root and, if so, could this be a possible cause for the nose bleed.  Also, would extraction of the tooth and antibiotics alleviate the symptoms.  The tooth in question is fairly worn with pulp chamber exposure as well as a 4 mm pocket on the distal aspect.  Enclosed are copies of the films on tooth 108 and a couple of the sinuses.  Any information and/or guidance you could provide on this case would be greatly appreciated.

Brett Beckman, DVM, FAVD, DAVDC, DAAPM
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