Long Term Failure with Interesting Initial Healing of a Lesion

Terry Pannkuk, DDS, MScD Instructional, Recall Observations

Can successful treatment of a lesion of endodontic origin fail again at a later date?

Case: Patient presented for several recall exams over the course of a decade eventually developing a recurrent abscess after initial osseous regeneration

Patient: 46 year-old male with hypothyroidism (controlled)

Chief Complaint:
Asymptomatic (1999, 2000, 2003)
Pain and Swelling (2011)
Asymptomatic (2012)

Dental History: The author retreated a previous failing root canal system (#30) 11 years prior to the recall examination at which time the crown was planned for replacement and a chronic lesion was noted on a tooth previously obturated with carrier obturators. A recall examination in 2003 demonstrated resolution of the periapical radiolucency and no signs of endodontic disease. The patient returned in 2011 with pain and swelling associated with the tooth. Endodontic retreatment was performed again and complete resolution of endodontic disease was again noted one year later (2012)

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