Case 35 Apicoectomy vs. Orthograde Retreatment


Pre-operative x-ray #19

Root canal completed by another provider with separated file in ML canal.  Tooth is extremely symptomatic.








Post-operative x-ray #19


Surgical approach was decided upon and no fractures noted. Three retro fills were placed, and a separated file was removed from ML canal with ultrasonics.  Despite large size of lesion and the amount of bone loss, the prognosis was good. 





3 month check-up #19

Patient is asymptomatic and healing was noted.







9 month check-up #19

Patient continues to be asymptomatic and the bone almost completely filled in








Comments:  Separated instruments are just a way of life for those who do root canal therapy.  The instrument itself is not a problem.  What it represents is: a blockage of a possible dirty canal.  In this case, I just speculated that the separated instrument was the cause of this patient's problem.  Do I know this for sure? No.  Therefore all canals were retrofilled.