Supplementary approaches in endodontic retreatment

Background : There are some factors can cause endodontic failure such as inadequate in cleaning or shaping step, non hermetic obturation, or poor restoration, which can cause bacteria multiply. Purpose : To report the management of endodontic failure with nonsurgical treatment. Case : 46-year-old woman came to Airlangga Dental Hospital Conservative Dentistry Department to treat her upper right tooth which show symptomatic pain in the last 2 weeks. The tooth has been treated and crowned with porcelain fused to metal about 10 years ago. Clinical examination show the presence of fistula on premolar buccal gingiva, react to percussion. Radiographic examination show not hermetic obturation in one root canal and radiolucency in the periapical area. The diagnosis for maxillary first premolar is previously treated tooth with chronic periapical abscess.. Treatment : Crown and post was removed from the tooth, and endodontic retreatment was done. Follow up 6 months after the retreatment show no reaction to percussion, and radiographic examination show no enlargement periapical lesion. Conclusion : Nonsurgical endodontic retreatment always become the first choice to resolve endodontic failure for previously treated tooth.Keywords : endodontic failure, maxillary first premolar, nonsurgical endodontic retreatmentCorrespondence: Yongki Hadinata W., drg. PPDGS Ilmu Konservasi Gigi Fakultas Kedokteran Gigi Universitas Airlangga, Surabaya. Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya.

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Persistent Apical Periodontitis: Bacterial Taxonomic Analysis and Treatment Through Intentional Replantation

Journal of Dentistry and Oral Sciences ◽

10.37191/mapsci-2582-3736-2(3)-032 ◽

2020 ◽

Author(s):

Fernando Eduardo Coria-Valdiosera

Keyword(s):

Antibiotic Therapy ◽

Root Canal ◽

Resistance Mechanisms ◽

Apical Periodontitis ◽

Infectious Process ◽

Identification Of Bacteria ◽

The Right ◽

Apical Lesions ◽

Endodontic Retreatment

Introduction: The microorganisms own different resistance mechanisms that allow them to resist the chemo-mechanical cleanliness of root canal and antibiotic therapies causing the persistence of apical lesions. Methods: This clinical case describes a male patient diagnosed with pulp necrosis in the right lower central incisor due to trauma, which developed apical periodontitis manifesting itself extra orally. Root canal treatment along with antibiotic therapy was performed, but because the infectious process persisted, endodontic retreatment and a new antibiotic therapy were carried out, however, the clinical evolution was not favorable. For this reason, the intentional replantation was chosen as the outright treatment, performing apicectomy and curettage of the periapical lesion, from which the isolation and taxonomic study of microorganisms were carried out, with the respective antibiogram. Results: In the 10-day clinical follow-up, the extraoral infectious process disappeared almost completely and 6 months later, a complete repair of the bone tissue was observed on the tomography. Conclusion: A better understanding of the persistence of apical periodontitis was achieved by taxonomic identification of bacteria and the intentional replantation allowed to remove the apical biofilm gaining an excellent wound healing.

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