To Save or Not To Save? That Was the Question. A Seven Years Post Endodontic Treatment Outcome Follow Up

      

Case Study Number  368745

Patient was told seven years ago to remove lower right premolar and replace this tooth by an implant supported crown. Lack of periradicular tissues implied a guided tissue regeneration which, in turn implied a bone curetage close to the mental foramen. Estimated health risk: A possible permanent nerve paresthesia caused by a curetage or by an implant surgery close to the mental foramen on a patient with a narrow crestal mandibular bone. A possible failure of guided tissue regeneration which in turn, would impair implant osseointegration (or simply make the implant surgery impossible). Clinical examination revealed a mobility level of 2 and a sinus tract. Our findings on radiographic appearance: a large but a localized bony defect and a tooth that needed a root canal re-treatment. Our suggestion to the patient: To put aside the implant surgery and to invest in a root canal re-treatment with a few Ca(OH)2 replacements. The patient had to be patient (and faithful) for a few months in order to monitor progressive periradicular tissue healing.

Results: Per and post operative control X ray films show a progressive, then complete healing of periradicular bone tissue. In this case, root canal retreatment proved to be a safe predictable way of saving that tooth at half the cost of an agressive implant surgery.
Now, 7 years later, the tooth has it’s own casted post, a PFM crown and it’s mobility level came back to zero. And above all, patient is now completely safe from any paresthesia risk.