Treatment failure

You can be a very experienced clinician you read tons of literature and use relevant protocols but never have 100% success treating apical periodontitis. This case was  NSRTx retreatment of first upper molar after Resorcinol Formaldehyde technique with CAP on buccal roots.

Pre-, intra-, and postoperative X-rays of NSRTx
Pre-, intra-, and postoperative X-rays of NSRTx September 2013
postoperative view of pilp chamber
postoperative view of pilp chamber
Pain and swelling in May 2014. Patient took antibiotics for 5 days which helped just partially.
Pain and swelling in May 2014. Patient took antibiotics for 5 days which helped just partially.
both buccal roots were surgerized
both buccal roots were surgerized
The only reason of failure I could find was black spot on MB root on the very tip of the root. After  shaving one more millimeter I saw only GP.
The only reason of failure I could find was black spot on MB root on the very tip of the root. After shaving one more millimeter I saw only GP.
Final view of obturation with BC putty
Final view of obturation with BC putty

 

 

 

 

 

RELATED POST

Apical perf healing (by Ilya Mer)

What a pleasure surprise came yesterday to my clinic. Tooth #36 with apical perf healed completely 3 years after treatment.…

Red Russian cement molar surgery (by Ilya Mer)

Red Russian cement was very popular in former USSR countries and unfortunately still in use in some cases. The main…

12 month CBCT recall after MB root surgery (by Ilya Mer)

Missed anatomy is the most frequent cause of apical development. In first upper molars definitely MB2 is mostly missed canal.…

When the surgery is the only option (by Ilya Mer)

To tell you the truth my therapeutic nature opposes an idea to do surgery in case of unfounded and untouched…