Non-Surgical Endodontic Retreatment after Unsuccessful Apicectomy: A Case Report

Introduction: Endodontic failure may arise mainly from persistent intra-radicular infection from remaining bacteria in the root canal. As a result, retreatment is the most appropriate way of dealing with failed cases. However, many clinicians choose to perform periapical surgery, on the grounds that it is simpler and has immediate results. The resected teeth with insufficient root canal treatment may fail again. In this case, orthograde retreatment can have favourable results. The aim of the present study was to describe a case, where an orthograde retreatment was applied in symptomatic upper premolars that had already resected. Methods: This case report describes the orthograde retreatment of upper premolars after unsuccessful apicectomy. A 32-year old female patient presented complaining of extra-oral fistula and intra-oral swelling associated with the upper left premolars. Radiographic examination showed that the premolars had received inadequate endodontic treatment and presented periapical radiolucency. An orthograde retreatment was performed in both of them. Results: After 15 days, the teeth were asymptomatic and the intra-oral swelling had disappeared. In addition, no exudate was found in the root canals and the extra-oral fistula was no more active. At a 3-year recall the region appeared normal. Conclusions: Orthograde retreatment is a treatment option in teeth with unsuccessful apicectomy and poor endodontic treatment.