Was retreat possible?

A 54 year old patient contacted our office regarding tooth #20. She was told that a retreat would solve the problem she was having. This tooth was treated 2-5 years prior to her visit with us. A fistula had recently developed so her dentist gave her an antibiotic. This fistula was causing the patient pressure and discomfort.

After examining the 2-D image received by her general dentist, it was unclear was to what was going on. It was ultimately decided at a CT scan would provide us an answer.

The CT scan showed that there was a post that was placed from the crown to the apex of the tooth. Upon closer observation, there were fracture lines at the apex. There was also bone loss on the cortical plate that was consistent with a fistula.

There were two options as to what to do. Option 1: an exploratory was possible along with an apicoectomy. However, the post was of a size that the strength on the dentinal wall was compromised. This would result in a limited long-term prognosis. Option 2: an alternative long-term solution was to extract the tooth and have an implant placed.

Following up with the patient a few weeks later, she decided to have the tooth extracted and was in the works of consulting a Prosthodontist for an implant.

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Laser Endodontics LLC - Mary Ann Choby, DMD, MS

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