Surgical Management of Apical Lesion

Patient R.M. presented to our clinic for continued management of tooth #12, which had previously undergone two endodontic treatments by another dentist. Despite these interventions, the periapical lesion remained unresolved. A preoperative periapical radiograph revealed an fractured instrument associated with overextension of the root canal filling material beyond the apex. Preoperative periapical radiograph. An orthograde retreatment was initiated, involving complete removal of the previous root canal filling. The existing gutta-percha extruded beyond the apical foramen was carefully pushed out rather than retrieved coronally, to minimize the risk of further apical damage. The fractured instrument was successfully removed using an ultrasonic tip with a brushing motion along the canal wall. A thorough three-dimensional chemo-mechanical disinfection of the root canal system was…