Calcified Tooth – History of Apical Surgery

Orthograde retreatment of a previously resected tooth A 54-year-old female patient presented in December 2023 for evaluation of tooth #22. Her medical history was non-contributory. She reported a car accident during adolescence. Twelve years earlier, she had experienced pain on tooth #22. Due to treatment difficulties at that time, she was referred for apical surgery, which was performed in March 2011 At presentation in 2023, the patient was asymptomatic. There was no swelling, sinus tract, or mobility. Clinical tests including palpation, percussion, and bite test were negative. A PA radiograph revealed a well-circumscribed periapical radiolucency associated with a previously resected root apex. The canal appeared severely calcified with evidence of pulp canal obliteration (PCO) and an extensive prior access cavity.…