Fig. 1

A 27 years old female reported a recurrent abscess on the upper right second molar. She had a primary treatment when she was young and a retreatment in 2017. Even if the final treatment looks adeguate, the tooth remained always symptomatic.   

Video shows all the clinical steps.

  1. Removal of Guttapercha with rotary files
  2. Analysis of the anatomy 
  3. Confluences detected thanks to a micro aspirator
  4. Removal of the  all the inner hard part and calcification 
  5. Apical anatomy cleaning and disinfection
  6. MTA apical Plug
  7. During the second appointment a Bulk flow composite has been placed inside the root canal system
Fig. 2

Post operative scenario.

 

Mta apical plug and final xray after root back filling made with bulk composite.

 

CHIEDERE CONTROLLO A TONINI PRIMA DELLA PUBLICAZIONE

Fig. 3

6 months follow up x-ray shows the healing of the lesion

Conclusions

Do better is the main goal when an Endodontist starts a new retreatment, but sometimes it’s necessary to take a decision in order to achieve the main percetage rate of success.

Bibliography

Paul R. Cooper, Henry F. Duncan, Matthias Widbiller, Kerstin M. Galler. Treatment of Immature Teeth with Pulp Necrosis.  Book Editor(s):Josette Camilleri. First published: 19 March 2021 https://doi.org/10.1002/9781119513568.ch3

G. Krastl, R. Weiger, A. Filippi, H. Van Waes, K. Ebeleseder, M. Ree, T. Connert, M. Widbiller, L. Tjäderhane, P. M. H. Dummer, K. Galler. Endodontic management of traumatized permanent teeth: a comprehensive review

E. Mandel, C. Bourguignon-Adelle. Endodontic retreatment: a rational approach to non‐surgical root canal therapy of immature teeth

European Society of Endodontology (ESE) developed by:, G. Krastl, R. Weiger, A. Filippi, H. Van Waes, K. Ebeleseder, M. Ree, T. Connert, M. Widbiller, L. Tjäderhane, P. M. H. Dummer, K. Galler. European Society of Endodontology position statement: endodontic management of traumatized permanent teeth