When a root canal treatment fails due to persistent infection, missed canals, or inadequate sealing, a retreatment procedure can help save the natural tooth. This case highlights the successful endodontic retreatment of tooth 47 in a patient who presented with pain and discomfort.

Patient’s Chief Complaint

A patient reported pain in the lower right back tooth (tooth 47), which had been previously treated with root canal therapy. The discomfort was persistent, especially during chewing, prompting further evaluation.

Clinical & Radiographic Findings

  • Tenderness on percussion was noted irt 47.
  • Radiographic evaluation revealed incomplete obturation and possible missed canals.
  • Decision: Endodontic retreatment was planned to eliminate the infection and preserve the tooth.

Treatment Procedure

1. Access and Canal Location

  • Existing restoration and root filling material were carefully removed.
  • On exploration, two canals were located in the mesial and distal roots.

2. Biomechanical Preparation (BMP)

  • Thorough cleaning and shaping of the canals were carried out using rotary and hand instruments.
  • Irrigation protocol included sodium hypochlorite and saline to disinfect the canals effectively.

3. Intracanal Medicament (ICM) Placement

  • Calcium hydroxide was placed as an intracanal medicament to eliminate residual bacteria.
  • The tooth was temporized, and the patient was recalled after 7 days.

4. Obturation

  • On the subsequent visit, the canals were dried and checked for complete healing.
  • Obturation was performed using gutta-percha with a bioceramic sealer, ensuring a three-dimensional seal.
  • Post-obturation radiograph confirmed the accuracy and quality of the fill.

Outcome and Follow-Up

  • The patient reported complete relief from pain after retreatment.
  • Tooth 47 was restored and reinforced to ensure proper function.
  • A follow-up appointment was scheduled to monitor periapical healing.

Why Bioceramic Sealer?

Bioceramic sealers are biocompatible, antibacterial, and provide an excellent seal compared to conventional sealers. Their ability to bond to dentin and expand slightly upon setting ensures long-term success in root canal retreatment cases.

Key Takeaway

Endodontic retreatment using advanced sealers like bioceramic material can successfully resolve persistent pain and infection, preserving the natural tooth and restoring function.

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