Case 42 What happened?

Pre-operative x-ray #8


Patient is asymptomatic - digital x-ray shows a metal instrument or some kind of metal filling material bent at the apex of tooth #8. General dentist describes root canal treatment completed prior to 1991.









Photo showing object





Metal instrument in periapical lesion was not connected to the instrument or file in the canal. It is not a silver cone. The instrument or file had obviously corroded off at the apex of the canal system.


Photo of object (hemostat for scale)






Surgically treated, instrument in the canal could not be removed via apex.  If periapical healing does not occur, then retreatment may be an option.








Comments:
Retreatment is usually the most obvious option when root canal therapy fails.  However, a surgical approach is a valid option when retreatment may not be adequate.

Best advice is to have a periapical x-ray on a tooth prior to placement of a crown.