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Apical resection failure: Retreatment of the tooth

Year: 2024
Type: article
Study design: Case Report
Abstract: In post-endodontic persistent lesions, the treatment options are orthograde retreatment or apical surgery. This study reports orthograde retreatment of a tooth, previously underwent apical resection. A 19-year-old female patient with no systemic disease presented to the endodontic clinic due to a sinus-tract in the upper right jaw. The patient had endodontic treatment of the maxillary right second premolar three years ago and apical resection without retrograde filling one year ago. The tooth was diagnosed as asymptomatic apical abcess, and ortograde retreatment and MTA apexification was planned, because of the open and irregular apex. The tooth was isolated, and the access cavity was prepared. The infected root canal content was removed using the Endoart Retreatment files (Inci Dental, Turkey, Istanbul). The root canals were prepared along the working length determined with the apex locater, and 2.5% NaOCl was used for irrigation. Calcium hydroxide was applied as root canal medication for three weeks. In the second session, it was detected that the sinus-tract had closed. MTA (Produits Dentaires, Vevey, Switzerland) was applied as an apical plug, and the rest of the canal was filled using the warm obturation technique. Subsequently, restoration was completed with composite resin. In 8-month follow-up, the tooth was asymptomatic and periapical healing was observed. If the failure originates from canal content, apical surgery without retreatment may negatively affect prognosis, especially if retrograde filling is not applied. The clinicians should consider the origin of the post-treatment disease and plan treatment accordingly.
Language: English
Subfield: Oral Surgery
Field: Dentistry
Open Access status: gold
Estimated APC paid: $2,550
OpenAlex ID: W4403544212
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