A A ss-year-old woman visited an emergency clinic (Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh) with a five -day history of dental pain. Her medical history included hypertension that was controlled with a calcium channel blocker, type 2 diabetes that was controlled with glyburide and an allergy to penicillin. The patient reported that her mandibular left second molar had been restored several years earlier. Within the previous week, however, she had begun to experience increasingly intense, throbbing pain and pain when chewing with that tooth. In an effort to relieve the discomfort, the patient took 200-milligram ibuprofen tablets every few hours, which provided only minimal relief. Several days later, she sought treatment. The extraoral examination revealed no facial swelling.