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importance of diagnosis case report | 37roots1 2016 A new CBCT scan (i-CAT, Imaging Sciences Inter- national; Fig. 9) confirmed that the third molar had aninternalsinustract,whichhadcreatedthefistula. This could all be solved by root canal treatment on the molar, followed by a crown and follow-up treat- ment, with a good prognosis for overall long-term success. The patient was happy to hear that and re- quested treatment as soon as possible. The root canal was treated (Fig. 10), using the TF AdaptivesystemforshapingandEndoVacforchem- ical preparation according to the “A” sequence of ir- rigation protocol, followed by 3-D obturation of the root canal system using the Elements Obturation Unit (Fig. 5). Follow-up records were taken (Figs. 11 & 12), with radiographic control to check for bone healingandexternalfacialphotographstocompare. The patient was extremely satisfied that her molar could be preserved. Conclusion These clinical examples illustrate the importance of diagnosis as the main piece of the puzzle the im- portance of “finding it”. Today, the state-of-the-art approachinendodonticsrequirestheuseofsophis- ticated equipment and software to complement the expertiseandexperienceoftheoperator.Onlyallthis in concert allows us to put the pieces of the puzzle together. The patient’s subjective account can lead us or sometimes mislead us. We should keep in mind that most of our patients do not know how anatomy worksorthatpaincanbereferredfromadistantarea inthemouth.Thatiswheretheobjectivehistoryand adequateanalysisofthediagnosticandclinicalfind- ings lead the way. Fixing the problem requires the most biological approach to root canal treatment, putting our clini- calexperiencetoworktoprovidethebesttreatment for our patients. Once we are sure we have done the best we can to eliminate all kinds of aggressive con- ditions and disease, we need to let nature take care of the healing process._ The author would like to thank Yulia Vorobyeva Sleiman, interpreterandtranslator,forherhelpwiththisarticle. References [1] “Find it, fix it, and leave it alone”—an axiom attributed to Dr Andrew Taylor Still, the founder of osteopathy, and recorded by his students and followers. [2] PublishedearlierinSleiman,P.,“‘A’sequenceofirrigation”,roots international, 1 (2014), 14–7. contact Prof.Philippe Sleiman is an endodontist at the Vilafortuny clinic and training centre in Dubai in the UAE,the AdvancedAmerican Dental Center inAbu Dhabi in the UAE and theAmerican Dental Clinic in Dubai.He can be contacted at profsleiman@gmail.com Fig.11 Fig.12 6 weeks later 6 weeks later