Sometimes you reach the end of the line.
Upper first molars provide us a unique opportunity when it appears that all other endodontic options have been exhausted.
The root amp.
Posttreatment disease can exist secondary to surgical as well as nonsurgical treatment. If this disease is restricted to one root, the option of removing the diseased root may be a viable one.
Tooth #14
Previously treated
Chronic apical abscess
Clinical findings:
Deep periodontal probing on the mesiobuccal root, episodic swelling, tenderness to palpation, history of nonsurgical and surgical treatment. After surgical access, extensive granulation tissue was discovered, and the root amputation was completed without incident.
Postop
3 month recall
In this case, the bony destruction was limited to one root. Upon surgical access, if the destruction had communicated with other roots, I would have recommended extraction.
I will continue to recall this case going forward.
Its encouraging to see root resection techniques being applied an a sensible manner. As an endodontist, I have suggested this therapy on numerous occasions to referring dentists. All too often, the restoring dentists opts for extraction and implant vs. the root amputation. I think there is a fear of failure of the technique when this is really a tried and true treatment option.