Case 49 Apical Surgery Without the Benefit of Previous Root Canal.

Pre-operative x-ray #28

Patient referred for the treatment of tooth number 28. The buccal tissue was swollen and the patient very symptomatic. The pulp chamber could be seen in the digital picture, but the canal system appeared sclerosed.

X-ray #28

The canal system could not be negotiated too the apex so an alloy was placed and apical surgery scheduled.

Immediate post-operative x-ray #28

Apical surgery completed with a IRM retrofill.

13 months POT x-ray #28

13 months POT. Patient is asymptomatic. Apical healing appears complete.

Comment: Even though a canal system may appear sclerosed it is usually necessary to try and negotiate. Apical surgery is an option if orthograde is unsuccessful.