CASE STUDY
Orthograde Root Canal Retreatment
Patient age | 45 |
Patient sex | Male |
Tooth | 16 |
Chief complaint | My tooth is sore on biting and pressure. From time to time I notice that there is a gum swelling next to the tooth |
Medical history | Nothing of note |
Dental history | Patient has had previous root canal treatment over 5 years ago |
Clinical evaluation | Tooth that is tender to percussion & palpation. Small fluctuant swelling associated with buccal alveolar mucosa |
Image on right: Pre operative periapical radiograph of the tooth 16


Diagnosis | Previously endodontically treated tooth with persisting chronic apical periodontitis |
Treatment Planned | Orthograde root canal retreatment, and referral back to general dentist colleague for permanent restoration and crown |
Alternatives | Tooth extraction and space rehabilitation with dental implant, bridge, or partial denture |
Prognosis | Fair |
Treatment | Orthograde root canal retreatment over two visits |
Chemomechanical debridement | Removal of previous root filling with ultrasonic instrumentation, retreatment files, and eucalyptus oil. Instrumentation with k-files to produce a reproducible glide path, rotary NiTi to finish the preparation & irrigation with NaOCl. MAF X2 and X3 (ProTaper Next) |
Dressing | Ca(OH)2 for 4weeks |
Obturation | With GP & AH Plus sealer. Warm vertical condensation technique. |
Orifice barrier | GIC |
Image on right: Pre obturation periapical radiograph of the tooth 16, checking cone length


Review | Healing in progress |
Patient reports | The tooth has been feeling good since treatment was completed. I can eat on that side again. |
PA demonstrates | Increased bone infill in comparison to post obturation PA taken 6 months prior |
Left image: Post obturation periapical radiograph showing obturation to length; right image: Review periapical radiograph showing increased bone infill around the mesiobuccal root