Endodontic re-treatment of lower right first molar
The patient was referred to Dr Edwards for endodontic re-treatment of LR6 which had been slightly symptomatic and requires a new crown. Radiographs showed a poor existing root filling and significant peri-apical inflammation.
All treatment options were discussed and the patient preferred to retain the tooth via endodontic re-treatment and new crown rather than extraction.
Occlusal access was made through the existing gold crown for ease of rubber dam clamp placement. A second un-treated distal canal was located using the microscope and ultra-sonics. The Gp was removed from the remaining three canals, all were then shaped to reciproc file size 40 and irrigated ultra-sonically with 2% sodium hypochlorite, 17% EDTA and 2% CHX.
Final obturation was completed using GP with bio-ceramic sealer. SDR was used to seal the GP and composite to provisionally restore the access cavity. The patient was referred back to his GDP for the crown.
Unfortunately many similar teeth are extracted these days rather than re-treated and restored.It is important to offer the patient the option of endodontic referral as many teeth which are restorable can be re-treated to a very high standard and the natural tooth retained.
All teeth with inadequate endodontic treatment should be re-treated prior to new crown or restoration (European society of endodontics).