Page 15 - The Beauty and Sorrow in Endodontics-Chapter 4 - Part 1

with ultrasonics and NaOCl solution to clean the split canal. Obturated

completed with warm vertical compaction technique. The post-op radiograph

showed both apical canals obturated (Fig 41D). Temporary restoration placed
and rubber dam removed. Post-op instructions given and the patient informed to

return in one week.
3-days post-op – Care call – The patient reported no more gingival swelling or

fever and she feels great.

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2) 34 Root canal treatment
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One week after 35 retreatment completion, the patient returned for 34
root canal treatment. Intraoral exam revealed slight tenderness to percussion at
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both 34 and 35, though not as sensitive as before anymore. Root canal
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treatment was completed on 34 under standard protocol. The post-op
radiograph showeda curved main canal with a properly filled lateral canal as

well (Fig 41E). The original 34- 35 splinted crowns were adjusted to prevent
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excess occlusal contacts and temporarily cemented back. Oral hygiene
instructions given.

3) Follow-up

3-months –The patient reported she is now able to resume normal masticatory
function on both teeth and experienced no discomfort since the

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treatments. The probing depths around 35 has reduced to 3-5mm
+
(originally 7 mm). Radiographic examination showed signs of
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healing around both 34 and 35 apical lesions (Fig 41F). Stressed
the important of oral hygiene with the patient.
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6-months – Both 34 and 35 respond normally to percussion and palpation tests
and exhibited healthy probing depths. The radiograph showed
reformation of lamina dura around both teeth (Fig 41G). Significant

improvement in oral hygiene observed. New post, core, and
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individual crowns were recommended for 34 and 35.
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1-year – Radiographic examination revealed completed healing of 34 and 35
apical lesions (Fig 41H). The restoring dentist had completed the
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crowns for 34- 37 but has opted to splint 34- 35 and 36- 37 again.
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