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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.

Radiograph 1

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.

Radiograph 2

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.

Radiograph 3

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).

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