Endodontics beyond the protocols

Over a year ago , I received a young patient accompanied by his mother for the management of a mandibular molar with an immature apex , pulpal necrosis , and a large periapical lesion . Analyzing the pre-operative radiograph , one detail stood out: The distal root showed a widely open apex , while the mesial root appeared more developed . This observation led me to propose a hybrid treatment approach : Revascularization on the distal root, and apexification on the mesial root. However, the patient's mother was not entirely at ease with that option, so we decided together to proceed with a more conventional option: Apexification using an MTA apical plug in both the mesial and distal roots .…