Endodontic. Case Study Number 502636
Patient has been referred to our dental clinic for a root canal retreatment evaluation on this very sensitive mandibular first molar. On radiographic examination, distal root canal has a blunderbuss apical opening caused by transportation along with some filling material overextension. Mesial root canals obturations fall short from the apical constriction probably due to apical ledges. There is also evidence of apical radiolucency.
Referring dentist question was: “Endodontic retreatment or extraction with an implant supported crown?” In order to answer that question we must ask ourselves the following questions: Is the tooth restorable? Yes. Can severe inflammation be eliminated by endo retreatment? Yes. Is this a straightforward endo retreatment case? No. Is this a good enough reason to pull this tooth? no.
Root canal filling material is removed, an untreated fourth canal is found in distal root.
All three previously treated canals have been shaped and cleaned all over again and fourth canal has also been treated.
This third X ray dental film displays root canal system filled with calcium hydroxide.
Symptoms subsided in the following hours and, 8 days later, tooth root canal system could be permanently filled.
Immediate post operative vu (and angled one). Is there some excess material past the blunderbuss apical opening? Yes. Is this an issue? No, but removing that tooth and replacing it by an implant supported crown would definitely have been one. in a 6 months post op control check up, this tooth was still symptom free.