Because of the huge post cemented within its root canal, the endodontic revision procedure to save her tooth seemed to be too difficult or too risky for the former practitioner to perform, consequently, patient has been offered a surgery to extract this infected and painful mandibular premolar and to replace it by a dental implant.
But patient would rather save her own tooth and asked for a second opinion. Patient has been explained that all it would take to preserve that tooth is to clean and disinfect contaminated canal area. In order to reach this contaminated area, a huge casted post must be removed from root canal, Sargenti paste must also be retrieved and a ledge has to be bypassed. Risks associated with this procedure where also explained. Patient choose to accept those risks.
It took twenty minutes in order to retrieve the casted post. Sargenti paste has been brushed away with ultrasonic tips from Spartan under high magnification (OPMI PROergo microscope from Carl Zeiss) and ledge was bypassed within 10 minutes working time. A number 10 file displays full canal patency on this X Ray dental film.
Calcium Hydroxide has ben used as an intra canal medicament and left in for 8 days
Tooth became asymptomatic on following appointment.
Final obturation (Pulp Canal Sealer + Gutta Percha).
Provisional obturation material: Clip from Voco.
Tooth has been saved no implant needed.