Case Studies

Should this tooth be retreated or extracted?

Patient: 76 year old female with controlled hypertension and arthritis

Chief Complaint: History of pain and swelling of one week duration (maxillary right posterior area)

Dental History: Root canal treatment on the maxillary right first molar (#3) had been performed by an endodontist 40 years earlier. Swelling and pain had developed a week earlier and was improving.

Significant Findings (Tooth #3): Moderate palpation and percussion sensitivity was observed upon testing. The radiographic series revealed a large diffuse radiolucency about the MB root and unfilled root canal systems with a parallel post having been placed in the palatal root. Periodontal probing depths were within normal limits with bleeding upon probing at the mesiolingual line angle area.

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Nonsurgical Versus Surgical Endodontic Retreatment on Teeth With Posts?

Patient: 65 year-old female with Hashimoto’s Disease and managed hypercholesterolemia

Chief Complaint: swelling on gums

Dental History: The patient reported a past history of root canal treatment (not recent) and a new crown on the maxillary left second bicuspid (less than a year). She started to notice some swelling associated with the area 3 weeks before the endodontic consultation.

Significant Findings (Tooth #13): a fluctuant buccal mass was noted opposite the said tooth which yielded slight discomfort when palpated. A periapical radiograph revealed a large periapical radiolucency and previous root canal treatment. The less radiopaque column of material in the coronal half of the root suggested a bonded fiber post. Clinical tests demonstrated Class 1 mobility, moderate percussion sensitivity, and periodontal findings within normal limits.

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