Retreatment of a lower second molar endodontic presenting with complex anatomy

Resumen

The purpose of this work is to present the management of a retreatment with complex anatomy, with the presence of broken instrument and filling material difficult to clear. We present the case of a patient with pain in an endodontically treated 37. The diagnostic tests showed the presence of apical periodontitis because of previous treatment failure due to complex anatomy and sub-obturation of the canals. Upon opening, the presence of an extra root was confirmed, in which a broken file and a materialsimilar to the composite used to fill the distal root was found. Due to the broken files, ledges and filling materials, it took three appointments to reach the working length of the entire root canalsystem. An irrigation protocol with 4.25% hypochlorite, 17% EDTA and 4.25% hypochlorite activated with Endoactivator was used. It was filled with the B&L®system. Followup at 13 months revealed healing of the previous apical periodontitis. Moreover, the tooth presented adequate function and esthetic. In conclusion, deep understanding of the internal anatomy of the teeth and their possible variations is essential. The broken instruments and alterations in the original anatomy are the primary obstacles to overcome for a successful endodontic retreatment, which should be the first option when confronting a primary treatment failure.