An endodontist case report. MicroEndodontic. Case Study Number 505026
Twenty five years old patient presenting with an abscessed maxillary molar. Diagnosis: Persisting disease after root canal treatment. Etiology: untreated second mesio vestibular root canal (MB2).
Two appointments were required to preserve that tooth:
First appointment: Crown and post removals plus root canal filling retrieval, MB2 location and calcium hydroxide insertion as a medicament.
Second appointment: Calcium hydroxide removal, irrigation, drying, final canal obturation gutta percha and Pulp Canal Sealer. Provisional filling material: Cavit.
Abutment is now symptom free and it is now all set for a casted post and permanent crown replacement.
A 6 months follow up dental Xray film shows an impressive regeneration of periradicular tissues. Compared to its initial size, apical lesion on mesio vestibular root shrunk up to 80%. Tooth is asymptomatic and functional.
A complex root canal retreatment does not have to mean extraction and replacement by a dental implant. A research study by Farzaneh et al. on treatment outcome in endodontic found an orthograde root canal retreatment success rate of 93% .
(Farzaneh M., Abitbol S., Friedman S. Treatment outcome in endodontics: The Toronto Study. Phases I and II: Orthograde retreatment. J Endod 2004; 30(9):627-633)