Endodontic retreatment and surgical complementation on a tooth with persistent fistula: case report

Flávia Carvalho SANTANA, Ricardo Silva ALVES, Renato Piai PEREIRA, Salatiel Ferraz Alves de SOUZA, Silvia Santos MELO, Rogério Vieira SILVA

Introduction: Biological chemical preparation repre- sents a fundamental step, as it promotes asepsis of the complex root canal system, enabling a biological environment favorable to the process of healing and repair of the periapical tissues. However, failures can occur in endodontic treatment and retreatment teeth, where surgical intervention is often indicated in these cases. Description: The patient, a 32-year old man, melanoderma, presented at the school clinic of a School of Dentistry in a city in Bahia, with a chief complaint of “blistering of the gums and bitter taste in the mouth.” Clinical examination revealed the presence of composite resin restoration on the mesial and palatine surfaces, and an active intraoral fistula in the vestibular region near the apex of tooth 22. By means of clinical, radiographic, pulp sensitivity tests and sinus tracking, a diagnosis of completed endodontic treatment was established, and periapical diagnosis of a chronic apical abscess. Afterwards, endodontic retreatment was indicated, consisting of two sessions of intracanal medication with calcium hydroxide, followed by an exploratory surgical intervention. Results: The proposed treatment protocol was effective. Clinical and radiographic success with healing of the active intrabuccal fistula and repair of the periapical tissues, as well as reestablishment of esthetics and dental function, was verified, in a period of twenty six months follow-up. At present, the patient is being followed-up semi-annually. Conclusion: it is necessary to emphasize the importance of safely performing reliable endodontic planning and prognosis, as well as follow up of the case, with periodic clinical and radiographic control.

Keywords: Endodontics. Root canal filling materials. Oral surgical procedures.

How to cite: Santana FC, Alves RS, Pereira RP, Souza SFA, Melo SS, Silva RV. Endodontic retreatment and surgical complementation on a tooth with persistent fistula: case report. Dental Press Endod. 2021 May-Aug;11(2):76-83.

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