Page 20 - The Beauty and Sorrow in Endodontics-Chapter 1

(Fig 16D) (Fig 16E)

6-weeks post-retreatment Six-months post-retreatment

radiograph shows gradual radiograph shows even more
healing of the apical lesion. healing of the apical lesion and the

patient has been asymptomatic
since the retreatment.

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A 30-year-old female reported that apical surgery of 22 was performed by an
oral surgeon three months ago when she was experiencing discomfort in that area. She

reported that it temporarily relieved the pain. Pre-surgery radiograph (Fig 16A)
revealed that a pulpectomy filled with Sargenti-like paste was completed instead of a
proper root canal treatment, a post was placed in the canal as well. The patient
reported that the oral surgeon had mentioned the best treatment was to remove the
crown and post and complete root canal retreatment, however, due to the upcoming

Chinese New Year at that time, she had opted for the fastest treatment: apical surgery
with incision and drainage. She reported being pain-free for a month and a half, but
that pain has reappeared again. The patient presented to the endodontic clinic with an

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abscess, and a sonogram with gutta percha revealed the source of pain to still be 22
(Fig 16B). Treatment options and their risks and benefits were explained to the patient.
She expressed a strong desire to preserve the tooth and opted for root canal
retreatment. Under a microscope, the post and old cotton pellets were removed, pus
was drained, and proper cleaning, shaping and obturation were completed (Fig 16C).

6-weeks post-retreatment radiograph revealed gradual healing of the apical lesion (Fig
16D). 6-months post-retreatment radiograph revealed more healing of the apical lesion
(Fig 16E), and the patient reported no more discomfort.

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Note: For more follow-ups on 22 and treatments for 12 and 11, please see “case 85”
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