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12 month CBCT recall after MB root surgery (by Ilya Mer)

All clinical cases Cases by Ilya Mer CT analysis Surgical endodonticsPublished April 15, 2016 at 5:14 am Comments Off on 12 month CBCT recall after MB root surgery (by Ilya Mer)

Missed anatomy is the most frequent cause of apical development. In first upper molars definitely MB2 is mostly missed canal.  Both approaches surgical and non surgical can be applied to solve this kind of problem. But what to do if the whole MB is missed? Is it mandatory to do surgical treatment instead of non surgical ReTx? In case of short root and/or in case you can retroprep to end of cast post and seal all depth of root canal it can be as successful as non surgical Tx. BTW in this specific case non-surgical Tx is not allowed because of cast post restoration and crown.

Preoperative situation. Massive cast post and crown on tooth 1.6  Missed MB root and PA lesion lifting maxillary sinus

Preoperative situation. Massive cast post and crown on tooth 1.6
Missed MB root and PA lesion lifting maxillary sinus floor

apical surgery was chosen as a first (and the only) treatment option. Alternative option was extraction. Root was shorten for 3-4mm which allowed to clean and fill it properly with MTA.

apical surgery was chosen as a first (and the only) treatment option. Alternative option was extraction. Root was shorten for 3-4mm which allowed to clean and fill it properly with MTA.

12 month CBCT recall shows complete bone healing around root tip and compact bone at osteotomy site.

12 month CBCT recall shows complete bone healing around root tip and compact bone at osteotomy site.

One more proof that surgery works as well as non-surgical treatment and common misconception that the only non-surgical cleans and surgery only seals should be changed in our mind.

 

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