18
Retreatment of a Maxillary Molar With Complex Internal Morphology
Gergely Benyöcs1 and Viresh Chopra2,3,4
1 Private Practitioner, Precedent Dental Office, Budapest, Hungary
2 Adult Restorative Dentistry, Oman Dental College, Muscat, Oman
3 Endodontology, Oman Dental College, Muscat, Oman
4 Bart’s London School of Medicine and Dentistry, Queen Mary University, London, UK
18.1 Introduction of the Case
Case of retreatment in a maxillary molar with six root canal orifices but four apical exits.
18.2 Patient Information
- Age: 43‐year‐old
- Gender: Male
- Medical history: Noncontributory
18.2.1 Tooth Information
18.2.1.1 Identification
Left maxillary first molar (Tooth 26)
18.2.1.2 Dental History
- Chief complaint: Patient reported with a chief complaint of moderate, diffuse pain on the left side.
- Clinical examination findings:
Periodontal probing depth was within normal limits; tooth was slightly movable. Palpation was positive more buccally than lingually.
18.2.1.3 Investigations
- Preoperative diagnostic assessment
- Preoperative radiological assessment
Preoperative PA radiograph showed previous root canal treatment with periapical radiolucency. The orthopantomogram (OPG) showed multiple root canals present in the oral cavity. The obturation is suspected to be short in the buccal canals (Figure 18.1).
18.2.1.4 Diagnosis (Pulpal and Periapical)
Failed previous root canal treatment with symptomatic apical periodontitis.
18.2.1.5 Advice
Retreatment of the previous root canal treatment.
18.3 Treatment Plan
The treatment was planned in two stages:
Figure 18.1 Preoperative PA and OPG showing previous root canal treatment in tooth 26. Periapical radiolucency can be seen in both the radiographs.
Stage 1
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