Case 5 Two Separated Files w/Apical Lesion

Pre Op - 2 separated files in #13

Patient presented with 2 separated files and an apical lesion.  Patient was symptomatic. Options were discussed ranging from retreatment to a surgical approach to extraction. Patient did not want to loose the tooth and I recommended a surgical approach which would have a more predictable prognosis.

Immediate Post Op - Partial separated files with retrofill

Portion of the separated file in the facial canal system is present as well as the file in the lingual canal.  Retrofills were placed that covered both separated files and the isthmus between. 

8 month Check-Up

Patient is now asymptomatic and the apical lesion has completely healed.

Comment: Most separated instruments are impossible to remove especially if the breakage occurs in the apical third of the canal system. If the apical foramen can be successfully sealed the chances of success are greatly enhanced. It is necessary, however, to  have these patients on a routine 3-6 month recall for 2-3 years.