VH Endodontics: Conventional endodontic retreatment and / or endodontic surgery?

Second Estrela et al. (2001) in determining success in endodontics fulfills criteria, involving clinical examination, radiographic examination and histopathological analysis. The professional resources available to the longitudinal control, based solely on clinical features (signs and symptoms) and radiographic features.

Already the second Bender et al, there are some clinical and radiographic criteria representative of endodontic treatment success: 1. No pain and edema,2. Lack of drainage and closure of fistula, 3. Teeth function in normal physiology, 4. Disappearance of periapical bone rarefaction.

According to Friedman and Stabholtz, endodontic point of view, every time there is a failure, the choice rests on two basic tenets: periradicular surgery or conventional endodontic retreatment, which, when properly prescribed, provide a good prognosis. Since the choice of either option depends on factors such as access to the channel, location and anatomic position of the tooth; involvement with prosthetic pieces, quality of endodontic treatment performed previously, and periodontal involvement.

Lopes et al. (2004) state that retreatment should be given when initial treatment: Upon radiographic examination, provide inadequate filling; By means of clinical examination, provide exposure of filling a root canal to the oral environment for more than 60 days, And failure or clinical examination and radiographs.

Even within the third clinical indication: Persistence of symptoms; discomfort to percussion and palpation; fistula or swelling, mobility, inability to chew. Radiographically, the presence of periapical bone rarefaction in areas previously lacking, including lateral rarefactions; periodontal ligament space increased by more than 2mm; bone repair in the absence of a periradicular rarefaction, an increase of a radiolucent area, no formation of new lamina dura, and evidence of a progression re root resorption.

Case Study:
History: Woman, 27, was referred to our clinic due to the presence of a fistula in the region of tooth 12. Absence of spontaneous pain and also to percussion.
Radiographically, observed the presence of previous endodontic treatment, with lack of filling material in the apical and lateral condensation disabilities. Radiolucency suggesting chronic periapical abscess.