Non-surgical endodontics in retreatment of periapical lesions - two representative case reports

Endodontic Retreatment of a Maxillary First Molar With Orthograde Retrieval of a Separated File by a Combination of Ultrasonic and File Braiding Techniques: A Case Report

The persistence of apical periodontitis after endodontic therapy can be attributed to biological causes or when the treatment approaches have proven insufficient in completely eradicating the intra-radicular infection. This case report describes the endodontic retreatment of a maxillary molar in which file separation occurred during the cleaning and shaping procedure. The separated file was successfully retrieved utilizing a combination of ultrasonic and braiding techniques. The field of ultrasonics has undergone a thorough investigation and has been demonstrated to be a conservative technique with minimal radicular dentin trephination. The braiding technique is also a conservative method that involves the use of several braided H-files to apply a gripping force, facilitating the extraction of foreign bodies. The utilization of this methodology has been documented in the endodontic academic literature.

Periapical Lesion: A Single-Sitting Root Canal Treatment

The aim of root canal treatment is to disinfect the root canal completely and prevent the progression of any periapical infection. Surgical treatment of periapical lesions is associated with many complications and challenges. This article describes the management of a periapical lesion of the right lower premolar in a single-visit root canal procedure using Metapex. The patient was observed for one week for any incidences of flare-ups.

Root Canal Retreatment and Intracoronal Bleaching on the Maxillary First Premolar

Introduction. Inadequate root canal preparation and obturation are potential causes of endodontic failure. Failed root canal treatment with intrinsic discoloration requires root canal re-treatment and intracoronal bleaching. Due to the extensive loss of hard tissues on occlusal area, the restoration requires intracanal retention with short fiber-reinforced composite. Case report. A 17-year-old male patient came to the Clinic of Conservative Dentistry Dental Hospital Prof. Soedomo. He reported pain and discomfort on maxillary first premolar while chewing after root canal procedure had been performed few months before. He felt unconvinience with the discoloration happened on those tooth. Patient had endodontic treatment one year ago and the tooth was restored with glass ionomer cement. Objective examination showed glass ionomer restoration was still in good condition, the tooth was sensitive to percussion but not to palpation, and showed no mobility. Periapical radiograph showed incomplete obturation with radioluscent around periapical region. Retreatment followed by intracoronal bleaching was performed under rubber dam isolation. Tooth was restored with short fiber reinforced composite and composite resin. After 3 month, patient was recalled for examine the previous sign and symptomps. Periapical radiograph showed diameter of periapical lesion was smaller and tooth functioned normally. Conclusion. Root canal retreatment and intracoronal bleaching are suitable options for teeth with failed root canal treatment and intrinsic discoloration