Success after endodontic retreatment: importance of cleaning and disinfecting the root canal system
DOI:
https://doi.org/10.21270/archi.v10i8.5095Keywords:
Endodontics, Retreatment, Conservative Treatment, Calcium Hydroxide, FistulaAbstract
Introduction: The persistence of microorganisms is one of the determinants of endodontic treatment failure, which occurs due to iatrogenesis, pathologies and negligence. To solve this problem, dental extraction or a more conservative treatment - such as endodontic retreatment, may be indicated. Objective: The aim of this article is to report a clinical case of failure of the primary endodontic treatment and the success in the retreatment approach that culminated in the positive outcome of the clinical case. Clinical case: A patient with painful symptoms on chewing in tooth 26 was diagnosed with chronic apical periodontitis with periapical radiolucency using clinical and radiographic propedeutics for endodontics. Endodontic treatment was performed and 1 year after its completion, the patient had a recurrent fistula and it was proposed to extract the tooth in question. Dissatisfied with the treatment plan, she sought a second opinion and endodontic retreatment was performed in multiple sessions with the use of calcium hydroxide as an option for intracanal therapeutic medication. After 60 days of intracanal medication, filling of the root canal system and dental rehabilitation were performed. Conclusion: The success of the endodontic treatment depends on the excellent cleaning and disinfection of the root canal system and consequently airtight filling; the persistence of microorganisms is one of the factors that can determine an unfavorable prognosis and a new endodontic reintervention can lead to success, despite radical alternatives, such as extraction and rehabilitation with implants. Through the presented clinical case, it is concluded that the meticulous planning and the execution of the treatment based on scientific evidence lead to the success of more conservative treatments for the patient and their satisfaction.
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