Coronal leakage as a cause of PARL (by Ilya Mer)

Русская версия

Patient suffered from irreversible pulpits of #36, RCT was done but patient noticed that the tooth still hurt him for 6 months after the treatment. Periapical film discovered PARL on the mesial and the distal roots. RD started re-endo, negotiated the distal canal and placed there iodoform based paste, no mesial canal was negotiated.

Preoperative X-ray
The main problem is the infection path to the pulp chamber - a lot of decay under the restoration allowed re-contamination of RC system. So the first step was caries cleaning and pre-endo buildup
Broken fragment blocked one of the mesials
Cleaning and shaping procedures were completed at the same visit and calcium hydroxide placed for 4 weeks.
Ready to obturation at the second appointment
final images of the tooth
4 month healing

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