Osteonecrosis and healing

The patient presented to the office with a large decay and a sinus tract associated with tooth 36, without symptoms. Radiographic examination revealed a large periapical lesion involving both roots, with furcation involvement. A root canal treatment was scheduled. Preoperative radiography Vestibular and lingual anesthesia was administered, along with intraosseous anesthesia using articaine with adrenaline 1:100,000 between teeth 36 and 37. After placement of the rubber dam, root canal treatment was performed using Procodile instruments. Final disinfection was carried out with Dual Rinse and saline solution, and the canals were obturated with Komet BioSeal sealer and Komet gutta-percha cones Post operative radiography At the one month follow-up, the sinus tract was disappeared but the patient returned complaining of discomfort between…