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.  Both approaches surgical and non surgical can be applied to solve this kind of problem. But what to do if the whole MB is missed? Is it mandatory to do surgical treatment instead of non surgical ReTx? In case of short root and/or in case you can retroprep to end of cast post and seal all depth of root canal it can be as successful as non surgical Tx. BTW in this specific case non-surgical Tx is not allowed because of cast post restoration and crown.

Preoperative situation. Massive cast post and crown on tooth 1.6  Missed MB root and PA lesion lifting maxillary sinus
Preoperative situation. Massive cast post and crown on tooth 1.6
Missed MB root and PA lesion lifting maxillary sinus floor
apical surgery was chosen as a first (and the only) treatment option. Alternative option was extraction. Root was shorten for 3-4mm which allowed to clean and fill it properly with MTA.
apical surgery was chosen as a first (and the only) treatment option. Alternative option was extraction. Root was shorten for 3-4mm which allowed to clean and fill it properly with MTA.
12 month CBCT recall shows complete bone healing around root tip and compact bone at osteotomy site.
12 month CBCT recall shows complete bone healing around root tip and compact bone at osteotomy site.

One more proof that surgery works as well as non-surgical treatment and common misconception that the only non-surgical cleans and surgery only seals should be changed in our mind.

 

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…

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…

Genre busting tooth (by Ilya Mer)

According to the laws of genre this tooth would be extracted  a year before. It's really looked awful - open…