Endodontic Re-treatment of Mandibular molar with Endo-perio lesion and broken instrument

Patient Ilya, 35 years male
Date 04.24
35 year old male patient named Ilya was referred by our General dentist collegue for endodontic opinion and management of severely tender tooth no. 36 having unsatisfactory previous endodontic treatment and periapical pathology.

On clinical and radiographic examination:

Previously endodontically treated 36 with periodontal abccess, deep pocket (>10mm), periapical pathology, J-shaped bone loss, broken instrument in mesial canal.


Chronic apical periodontitis of tooth no. 36

Treatment Process:

Treatment done in 2 visits.

Visit 1:

Under local Anaesthesia rubber dam application was done followed by access opening through old restoration under magnification (Microscope). Previoulsy filled canals were exposed and located. Old root canal fillings were removed with mechanical instrumentation and solvents one by one. After removing old filling from mesial canal the broken instrument was encountered obstructing the path to remaining canal. The instrument was then slowly bypassed with small instruments to reach the full length. Old fillings were then removed from other canals. All canals were then shaped, cleaned and intracanal medication was placed. Deep margin elevation was done distally and temporary restoration was placed

Broken instrument bypassed:

Visit 2:

Under local anaesthesia rubber dam application was done followed by cleaning of canals. After which the canals were dried and obturated (filled) using warm vertical compcation (Thermoplastic obturation). Composite core restoration was done. Patient has been advised follow up after 3 months.

Doctors who treated

Dr. Riyaz Godil
specialist endodontist;
languages: English, Arabic, Hindi
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