Selective mesial canal retreatment.
Colleague endodontist referred the patient for localization of the mesial canals with the aid of microscopy. Patient had a fistula related to the same root. Treatment of the distal canal was performed according to the rigors of technique and was therefore not accessed.
With the aid of microscopy and ultrasound, the canals were located and treated. There was remission of the signs and the patient was oriented for proservation.
Selective endodontic retreatment
In: Nudera.Selective Root Retreatment: A Novel ApproachJ Endod 2015; 1-7.
Summary
Root canal retreatment is traditionally considered an "all or nothing" treatment approach. It is usually recommended that all restorative and filling materials should be removed from all roots, regardless of the presence or absence of periapical pathology. In contrast, surgery to endodontics is not viewed as an "all or nothing" treatment approach, Traditionally, only the diseased root(s) are addressed by apical resection and apical filling.
The use of cone beam computed tomography allows a more accurate assessment of the periapical condition of individual roots. This information has introduced a new, conservative treatment alternative for previously endodontically treated teeth with multiple roots showing post-treatment disease. This new approach is called selective root retreatment. Advanced imaging allows the clinician to make predictable treatment decisions regarding the presence or absence of periapical pathology of individual roots, rather than making assumptions about the tooth as a whole. Selective root retreatment combines the non-surgical retreatment treatment approach with the selectivity of surgical root resection. In this way, retreatment can be limited to a single root or roots clearly showing periapical pathology while leaving the root(s) with no visible or perceived pathotic sign untouched.
Selective endodontic retreatment.
