A forty-four-year-old man attended the dental office for pain in the lower right mandible. Acute apical periodontitis was diagnosed in tooth 47 and apical periodontitis in tooth 46 with abscess and fistula and apical resorption in both roots. Root canals in tooth 46 were partially filled earlier. A starting diffuse lesion typical of acute apical periodontitis was seen around the root apex of the distal root of tooth 47.

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