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Clinical Concept: The Meaning and Purpose of Root Canal System Obturation

Obturation of a root canal system cannot be separated from the importance of debridement

Active Nonsurgical Decompression Technique for the Healing of Large Periapical Cystic Lesions

Sometimes, a periapical lesion can reach large dimensions jeopardizing the retention of the tooth itself and resulting in aggressive surgical treatment options with a huge impact in the quality of life of the patients

Patient: 35 year-old female, medical history noncontributory

Chief Complaint: Asymptomatic

Dental History: A 35 year old female patient was referred for evaluation and possible treatment of her right first mandibular molar (Tooth #30) after the accidental discovery of a large periapical lesion associated with her previously root canal treated tooth. The initial treatment was performed 10 years prior to the date of consultation with the author. The patient mentioned that she had bruxism and was wearing a soft mouth guard during the night.

Significant Findings (Tooth #30): The periodontal evaluation was within normal limits. Radiographic evaluation revealed large periapical radiolucency. CBCT evaluation revealed the magnitude of the periapical lesion in all 3 dimensions. No paresthesia was present.

Calcium Hydroxide Treatment:Validation of Healing

Fractured Roots, Gutta Percha Removal

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Post-endodontic Restoration