THE DENTAL EMERGENCY: This case was referred to us because of extreme pain associated with tooth #30. The root canal had been performed by the restorative dentist who had done seemingly well done endodontic treatment and coronal restoration. As evidenced in the CBCT, we were able to identify the source of failure to be an untreated DB canal. Upon access and canal location, we achieved immediate drainage for quite some time. To considerations for this case:
1] The treatment was completed in one visit because we were able to achieve a completely dry canal system after disinfection.
2] We decided with the restorative dentist to selectively treat the distal canal only for the reasons that there was only evidence of periapical pathology associated with the distal root, the pre-existing endodontic treatment appeared adequate, the crown was recently done. Whenever we choose to pursue selective root retreatment, our patients can be confident knowing that we will rectify any pathology associated with the root(s) not initially addressed should it arise. This was no different here. In this way, we were able to keep the endodontic access smaller despite having to also remove a fiber reinforced post.