This patient has a very common problem that often goes undetected on routine evaluation.  There is a fracture on the crown with no pulp exposure and a probe cannot be placed into the pulp cavity.  Reparative dentin has sealed what may have once been a complicated crown fracture.  Without radiography this tooth would appear normal otherwise.

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Radiographically there are periapical lucency is seen surrounding both roots.  Root canal therapy or extraction are the options for this tooth.  Leaving it will allow the bone destruction to progress.  Pain is very likely a problem with these patients although almost none will be able to demonstrate it to the owner.

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