Case 24 Surgical Approach Multiple Teeth

Pre-operative x-ray

Periapical abscess approximately 2cm across with de-vital #22 & #25.  Root canals on 23 & 24 were completed some time in the past. Patient is symptomatic.

Immediate post-operative x-ray

Non negotiable canals in both #22 & #25.  No attempt was made to try to negotiate the canal space in #22 as there was no obvious canal visible. #22-25 were retrofilled.

4 month post-operative x-ray

Bone fill in is very apparent and all symptoms are gone.

Comments: 

Lower anteriors are very difficult to treat and their premature loss poses a very difficult restorative situation. In this instance, it was decided that retreatment of #23 & #24 would not be beneficial in the long term and a surgical approach would be more predictable as far as healing was concerned.