Reversing an indication for extraction

Sponsor: Angelus
Author: Dr. Rodrigo Vivan

RESUME
The patient presented to the dental office for a new evaluation of tooth #46. She had previously consulted two dentists, both of whom had recommended extraction. Upon examination, the tooth exhibited grade II mobility and distal caries. Radiographic and tomographic images revealed apical periodontitis in both roots, including the furcation area.

Coronal access was performed, and instrumentation was carried out up to size 40 in all four canals, followed by intracanal medication with calcium hydroxide. After 30 days, the canals were re-irrigated, and chemical activation was performed, followed again by the placement of calcium hydroxide paste.

At the third appointment, 30 days after the previous visit, root canal obturation was completed using Bio-C Sealer (Angelus, Londrina, Brazil), and the cavity was sealed.

After eight months, radiographic and tomographic follow-up showed complete healing of the periapical lesion, including the furcation area. Clinically, the tooth is asymptomatic and functional.

These findings suggest that proper disinfection, combined with the use of a bioceramic sealer (Bio-C Sealer), can lead to satisfactory outcomes in cases of pulpal necrosis.

IMAGES

INITIAL XR

IMMEDIATE POST OP XR

8 MONTHS POST OP XR

INITIAL CBCT IMAGES

8 MONTHS PO CBCT IMAGES