This is an example of periodontal disease causing bacteria to have access to the dentinal tubules, entering and killing the pulp and producing a periapical lucency.  This patient was seen in Atlanta today.

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Slight bleeding is present due to probing.  Prior to probing no abnormalities were present in this 3 year old papillon.

Bone loss is present adjacent to the right mandibular fourth premolar (black arrow).  A periapical lucency is present adjacent to the mesial root (white arrow)

Any granulation tissue present is removed paying particular attention to the region adjacent to the first molar.  This is generally done with periodontal curettes or with a fine diamond bur.

Postoperative radiograph.

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