Patient satisfaction

In the following case I was able to provide a young patient with an aesthetic solution to a failed root canal treatment, without compromising the long-term performance of the tooth.

Initial diagnosis
A 12 year old female patient had been experiencing occasional pain with her LL6 molar ever since it had been filled, and complained that “it did not look like a tooth”. Tests showed that the molar was non-vital, and radiolucency indicated a failing root canal treatment.

The options were discussed with the patient and her parents. I advised against leaving the tooth as it was, because the patient was experiencing intermittent pain. The alternatives were to have non-surgical re-root canal treatment, surgical apicectomy and retrograde root filling, or extraction. It was decided to proceed with root canal re-treatment and subsequent restoration with a direct composite filling, if at all possible.

Treatment stages
At the first treatment appointment, the old filling was removed, revealing suppuration around the three existing gutta percha cones. The disto-lingual canal had not previously been located. Patency was achieved in all four canals, which were then medicated before a provisional dressing and restoration were placed.