Emergency appointment for a recurrent acute pain on top left side. Root canal casted post and crown have been performed on this second maxillary molar one year ago. Patient is 24 years old, cannot eat on that side and he has been prescribed multiple regimen of antibiotics for this issue. No swelling, no mobility, no deep isolated pocket upon probing. Prognosis is good. Decided not to remove the crown because patient wanted to keep it a few more months. Thus, the post has to be drilled of through the crown.
An access has been drilled through the crown , through the casted post up to the pulp chamber level. Due to the non precious alloy it was made of, it took 60 minutes with an electric hand piece and quite a few burs to get through this post.
Blood exudate and pus drained through the palatal root canal entry and patient has ben rescheduled for root canal revision.
Patient came back, tooth was asymptomatic and access through the casted post had to be enlarged in order to locate MB and DB root canal entries
This challenging root canal procedure has been performed by Dr Pierre Pizem , a general practitioner offering endodontic services for the last 28 years. This procedure took him three appointments totalling 4 hours chair side working time in order to save that natural tooth.