Case Study: Endodontic Retreatment of Periapical Lesion.

September 5, 2024 blog01

Dr. Sameer Jain’s case study details how to retreat an extensive periapical lesion by locating a missing MB2 canal to resolve a chronic infection and alleviate patient symptoms. 

Dr. Sameer Jain, board-certified endodontist, details how Komet’s ReStart system helped him successfully complete a retreatment procedure. This system proved to be a dynamic, effective and safe solution.
 
The patient presented with a complaint of pain when chewing, affecting tooth #2, which had been previously treated endodontically. The pain was localized to the upper right quadrant, specifically in the MB root due to the missed MB2 canal. 

After a thorough examination, I identified an extensive periapical lesion, with a previously separated file in the MB canal. A porcelain-fused-to-metal (PFM) restoration was present, and I found that the tooth tested negative to cold, showed moderate sensitivity to percussion and palpation and had a buccal sinus tract. 

Given the diagnosis of a chronic apical abscess and the favorable prognosis, a retreatment plan was devised. The primary objective was to locate the MB2 canal and retreat the remaining canals to resolve the chronic infection and alleviate the patient’s symptoms.  
 

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I began the retreatment by creating a precise pilot hole with the ReStart Opener. This initial step is crucial for setting up an accurate path for the subsequent removal of the old root canal filling material. 

ReStart Opener
ReStart Opener
 
Following the creation of the pilot hole, I used the ReStart Primary File to effectively remove the existing root canal filling. The innovative design of the ReStart files, which includes a safety tip, allowed me to confidently remove the material with control. The safety tip also ensured that the file could penetrate the root canal filling easily and effectively, minimizing the risk of procedural errors.

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ReStart File

 


The access preparation was completed using PermaFlow Purple and Cavit, ensuring a secure and durable temporary restoration.  
 
By the second visit, all symptoms had resolved, indicating successful retreatment and infection control. 
The system you use for retreatments is integral to reach your desired outcome. Using a system like Komet’s ReStart ensures a successful and painless procedure.

 

About Dr. Jain

Dr. Sameer Jain is an experienced board-certified endodontist with diverse clinical, academic and leadership experience. He is a relationship-driven and patient-centric clinician who believes in a conservative, minimally invasive approach to endodontic therapies for saving teeth.

His philosophy is to provide evidence-based treatments using the most advanced techniques, state-of-the-art equipment and microscopes to provide the best endodontic and restorative outcomes for his patients and referring dentists.

Over the years, Dr. Jain has created his niche in the endodontic specialty through his pioneering publications and contributions in dynamic navigation technology and minimally invasive endodontics. He lectures nationally and internationally on topics related to contemporary endodontics, endodontic diagnosis and CBCT, dental anesthesia and pain management, 3D-guided navigation and dynamic navigation.

 

About the Author

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Hannah Avery is Komet's copywriter and has been writing on the dental industry since 2021. She focuses on copywriting, social media management and content management in the dental industry.
 
 

 

 

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