Nonsurgical endodontic retreatment, first choice in recurrent infections: Case report

Abstract

Introduction: Nonsurgical retreatment of the canal system has become a routine procedure in modern dentistry, aimed at eliminating bacteria and achieving a three-dimensional seal to eliminate signs and symptoms and heal periapical lesions. Clinical case description: A 45-year-old female patient presented to a dental consultation due to infection in a previous root canal treatment of the upper right first molar. The patient reported the presence of a sinuous tract for two years. Diagnostic tests revealed positive percussion and palpation, and Grade I mobility. Radiographically, a well-circumscribed radiolucent area was observed at the apex of the palatal root. Pulp and Periapical Diagnosis: Previously treated tooth with chronic apical abscess. In the first session, the furcation perforation was sealed with bioceramic material, the canals were reopened, and calcium hydroxide intracanal medication was used. In the second session, the medication was replaced, and in the third session, the canals were sealed. Results: One month after the treatment was completed, considerable healing was observed, with no signs or symptoms. Discussion: We agree with the report by Matos G and Tanomaru Filho M. (2011) regarding the use of intracanal medication in this case. The advancement of technology has led to the use of different diagnostic methods, such as cone beam computed tomography (CBCT), magnification with a microscope, and rotary retreatment systems that help in more precise preparation with fewer traumatic injuries, as well as the use of various irrigants and irrigation techniques for canal decontamination and biocompatible filling materials with periapical tissue. Conclusion: Today, we have technology that makes these treatments increasingly easier to perform. Nonsurgical retreatment is an option for tooth preservation, avoiding more radical treatments, such as apical surgeries and extractions, with a demonstrated success rate of 86.8%.