Dr.

Patrick O'Malley
17 Longview
Newtown

18 February 2019.

Re: Mrs. Joyce Williams. DOB: 09.05.66.

Dear Dr. O'Malley,

Thank you for seeing Mrs. Joyce Williams who has been presenting a problem in tooth
37. She needs to complete endodontic treatment.

On 04.04.18, the patient had pain on tooth 37 after insertion of IRM temporary filling.
She returned on 23.11.18 with tenderness to percussion in the same tooth. After
access and debridement, three canals were identified, but the MB canal was difficult to
access.

Today, during instrumentation the MB canal was unable to continue beyond 8mm, so
Ledermis paste and Cavit were dressed.

Regarding her medical history, Mrs. Williams had a myocardial infarction on

07.06.2007. She is allergic to penicillin and is prescribed aspirin 100 mg every day.

She needs to conclude the endodontic treatment. Investigation of MB canal

obstruction must be done. PA radiograph exam was unable to determine the reason
for the obstruction.

Do not hesitate to contact me, if you require any further information.

Yours sincerely,

Eduardo Gouveia.