Heroic Retreatment of a Retreatment: Puzzle Case Part 1

Terry Pannkuk, DDS, MScD Complications: Advanced Management, Fractured Roots, Retreatment Strategies, Dismantling, Gutta Percha Removal

You make the call at the surprise decision point!

Patient: 52 year-old male in excellent health

Chief Complaint: Patient reported a bump on the gums above his front upper tooth

Dental History: Patient reported a history of prior orthodontics as a child and previous endodontic treatment performed on the maxillary left and right central incisors in 1970 (teeth #’s 8 and 9). Surgical endodontic treatment had been performed years ago after a recurrent infection associated with the maxillary left central incisor (tooth #9)

Significant Findings (teeth #’s 8 and 9): Percussion and palpation tests were within normal limits for both teeth. Periodontal probing depths were within normal limits for both teeth. A fistula with drainage was noted at the apical extent of the attached gingiva opposite tooth #9. Radiographic findings revealed slight PDL space widening with a slightly short root canal filling associated with tooth #8. Tooth #9 revealed a diffuse periapical radiolucency with a root filling filled 2-3 mm short of the radiographic terminus and a suspected “blunderbuss” apex.

Sign In

Subscribe to View the Case

There are 20 images included with this case summary.

Back to All Cases

Join The Discussion

1 comment

Commenting Guidelines Please make scholarly cited references or expert opinions suitable for publication. The comments can either be "pro" or "con" with references to the treatment philosophy. We encourage objectivity and detailed demonstration of knowledge/literature.
Harsh Amlani commented 8 years ago.

I would go for obturating the canal with MTA.

You must log in or create a free account to post a comment.

Related Cases

Master Class Instructional on Managing Calcified Canals Instructional, Clinical Endodontic Technique Instruction, Access, Complications: Advanced Management, Calcification
Recall (5 Years): Radix Entomolaris Instructional, Cleaning and Shaping, Complications: Advanced Management, Recall Observations
Hidden Missed Canal Diagnosis, Access, Cleaning and Shaping, Complications: Advanced Management, Missed Canals, Retreatment Strategies
Retreatment of a Perforated 3-Rooted Bicuspid Instructional, Complications: Advanced Management, Missed Canals, Perforations, Retreatment Strategies, Recall Observations
My First 30 Year Recalled Molar (failed twice) Complications: Advanced Management, Missed Canals, Recall Observations
The Aggressive Shoulder Crown Preparation Complications: Advanced Management, Difficult Isolation, Missed Canals