Jan 2011 she is having pain, percussion sensitivity, normal probings, adjacent teeth WNL. These teeth are diagnosed as: Prior RCT's w/ Symptomatic Apical Periodontitis.
Axial and sagittal views in CBCT verify that these are single canals incisors. It also shows us the extent of the bone loss prior to our surgical access.
Due to the large size of the canals and over extension of the previous RCT, it was recommended to treat these teeth surgically with an apicoectomy.
Apicoectomy completed with MTA retrofill.
At 6 month recall the teeth are fully functional and asymptomatic. Radiographs show impressive healing of the apical bone. Endodontic surgery can preserve the natural tooth, which then helps to preserve the periodontium.
UPDATE: 1 year recall. Pt asymptomatic, fully functional.
CASE #2The following case is a similar, double apicoectomy. The CBCT confirmed that there were no missed canals. The large posts and good crown margins were the reasons we chose surgery over non-surgical retreatment.
Endodontic surgery saves natural teeth.