The other side of facial cosmetic surgery

A 23-year-old female patient of Korean nationality reported to the Faculty of Dentistry, SEGi University with a chief complaint of pain in the upper left region of the mouth. The patient provided a history of intermittent, radiating type of pain around the maxillary left first molar persisting for one year. The consumption of cold and hot food were the aggravating factors for pain. On intra-oral examination, the maxillary left first molar and adjacent teeth were free of dental caries and periodontal disease. An intra-oral periapical radiograph revealed widened periodontal ligament space and loss of lamina dura around the root of the maxillary left first molar (Figure 1). The maxillary left first molar and left second premolar did not respond to electric and thermal pulp testing. Testing of the contralateral teeth elicited normal responses to these tests.

The patient revealed a history of facial cosmetic surgery done around 3 years back, undergoing chin augmentation and v-line surgery (orthognathic surgery) in Korea. The patient also revealed loss of sensation around the lower left region of the lip. An orthopantomogram showed titanium pins around the zygomatic region and the chin (Figure 2). The patient was advised that loss of sensation in the lower left region of the lip and loss of vitality of teeth could be possible sequelae of facial cosmetic surgery. Endodontic therapy was advised for the non-vital teeth.