Case 6 Apicoectomy of Two Teeth

Pre-op #12 &13 previous root canal therapy

Patient was very symptomatic and buccal tissue slightly swollen, both teeth were very tender to touch and pressure.

Options were discussed ranging from exodontia to retreatment to apical surgery.  I recommended that the most predictable outcome would be apical surgery on both teeth.

Immediate post-op #12 & 13 after apicoectomy w/retrofills

No fractures were noted and periodontally there were no issues.

3 month follow up xray

Apical healing on both teeth was observed and the patient was completely asymptomatic.

Comment:

Questions always arise as to why things are not healing. In this case, is it the over-extension of the filling material? I think probably not. Usually it comes down to the fact the tooth canal system has not been properly cleaned or due to the anatomy of the canal systems cannot be cleaned well enough. Once the apical foramen is sealed, the symptoms disappear and healing can occur.