530 - Management and restoration of a failed root canal treatment of a maxillary second premolar
Presented by: Gurkiranjit Kaur Sukhbeer Singh
Cardiff Dental Hospital
This case study looks at a failed root canal treatment of a maxillary second premolar and its successive re-treatment and restoration with a definitive core using composite. A 29 year-old female presented with a previously treated UR5 and symptomatic apical periodontitis. After clinical examination, it was found that the tooth has a large distal-occlusal restoration by her own General Dental Practitioner (GDP). Radiographical examination revealed very short roots and a possibly missed canal of the second premolar that may have caused the failure of her root filling. The tooth was then planned to have an orthograde re-root treatment. It was managed by the removal of the existing composite restoration to assess restorability followed by endodontic re-root treatment of the tooth. The patient attended our emergency clinic due to severe pain post-operatively during one of her visits. Upon completion, a new composite restoration was placed, and the patient was referred back to her own dentist for the provision of a suitable cuspal coverage restoration. At this stage, the patient reported no pain. This case illustrates the importance of managing patient expectations and detailing the risks and benefits of treatment provided, especially the discussion of post-operative pain in re-root treatment cases. Studies have shown that patients who have presented in pain pre-operatively are more likely to suffer from post-operative pain after each treatment visit. However, in this scenario, it is important to take the patient’s anatomical features like her shorts roots into consideration during initial discussions.
Consent Statement: Written informed consent for publication of their clinical details and/or clinical images was obtained from the patient/parent/guardian. A copy of the consent form is available for review by the the meeting organisers or the Editor of this journal..