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Root canal retreatment with removal of a fractured instrument and zirconia crown

Root canal retreatment with removal of a fractured instrument and zirconia crown

$Root canal retreatment with removal of a fractured instrument and zirconia crown$

Complaints:

The patient was referred from another clinic for root canal retreatment. During the previous endodontic treatment, an instrument fractured inside one of the root canals. A periapical X-ray revealed a separated instrument fragment located in the apical third of the root canal.

Diagnosis:

Apical periodontitis of tooth 3.6.

Treatment:

Following a comprehensive diagnostic examination, including computed tomography (CT), a detailed endodontic treatment plan was developed. The procedure was performed under STA computer-assisted local anesthesia with rubber dam isolation of the treatment field. The old restoration, remnants of the previous filling material, and caries-affected tooth tissues were removed, after which root canal retreatment and revision of the root canal system were carried out. Using a Leica M320 operating microscope, the fractured instrument was bypassed with the ByPass technique. Mechanical and chemical preparation of the root canals was then completed using both hand and rotary NiC and SOCO instruments to the physiological apices. After thorough preparation, the canals were hermetically sealed using the three-dimensional warm gutta-percha obturation technique. The tooth was restored with Estelite Asteria composite material, followed by tooth preparation and digital scanning for the fabrication of a prosthetic restoration. The final stage involved the fabrication and placement of a full-contour zirconia crown using CAD/CAM technology ("Budget" option).

In this case, the patient was referred for root canal retreatment after unsuccessful treatment at another clinic. An X-ray revealed a fractured instrument fragment in one of the root canals.

The examination confirmed apical periodontitis of tooth 3.6.

For treatment planning, a CBCT scan was performed to determine the exact position of the fragment and assess the root canal anatomy.

Using a Leica M320 dental microscope, the fractured instrument was bypassed with the ByPass technique, followed by mechanical and chemical canal preparation and obturation with warm gutta-percha.

After endodontic treatment, the tooth was restored with composite material and a zirconia crown fabricated using CAD/CAM technology.

Result:
The inflammatory process has been eliminated, the tooth preserved, and chewing function restored.

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Who performed the treatment:

The endodontic stage was performed by dentist-therapist
Radchenko Maryna .