Less is more. Titrated Retreatment
This gentleman presented with pain from an upper molar that had had a root canal treatment more than 20 years ago.
A 3-D image was taken of the area using small-field conebeam imaging. The 3-D image confirmed the presence of an area of inflamed tissue at the apex of one root and normal bone at the apex of the other two roots. The previous root canal treatment had been carried out to a high standard with a some difficulties encountered in the problem distobuccal (DB) root.
Findings of note in the DB root included
- A separated file mid root
- A broad root
- Calcified canal system
With a bit of luck and some patience I was was able to work past the separated file and clean the entire root. The Gentlewave Procedure was utilized to clean the complex canal system and bioceramic was used to seal the root thereafter.
CBCT 3D imaging made it possible to identify and treat only the affected roots. This is known as a titrated non-surgical endodontic retreatment.
The Gentlewave Procedure rendered the root ultra-clean and precious dentin was preserved.
Four separate portals of exit were noted on the post operative radiograph.