Page 42 - The Beauty and Sorrow in Endodontics-Chapter 2

(Fig 27B)

#
46 previously root canal treated with inadequate obturation (Fig 27C)
#
46 distal root loss of lamina dura (apical) and widened PDL (mid/coronal)
** The patient also sent over a panoramic radiograph taken when the upper and

lower bridges were placed in Vietnam 10 years ago (Fig 27D)
#
A Dx: 46
Pulpal: Previously treated

Periapical: Chronic apical abscess
Possible occlusal trauma/cracked tooth?

P Discussed proposed treatment plan with the patient. Informed consent obtained
to proceed.

#
1) Disassemble 46 crown to assess for presence of cracks  none observed

#
2) 46 root canal retreatment
Appt 1: Removal of old GP. Cleaning and shaping completed for the ML and

D canals (Fig 27E). Intracanal medication with NaOCl. Cotton pellet &

temp restoration placed (Fig 27F). No antibiotics required.
Appt 2: Temp restoration removal. Irrigation with NaOCl and ultrasonic tips.

Canals dried with paper points and ML+D canals obturated with warm
vertical technique. Fiberpost and resin core buildup completed. Final

radiographs taken (Fig 27G, 27H).
** It should be noted that the author had attempted to negotiate the MB

canal during both appointments without success. However, the final

radiograph suggests that it is possible the tooth only has one canal in the
mesial root. Hence, the author is looking forward to have chair-side CBCT

detector in the near future so these confusions can be clarified during
treatment.

#
3) New 46 crown (Fig 27I)

40