Case

Fractured Post removal and Endodontic Retreatment followed by Post Placement and a New Provisional Crown

Case presentation:

At routine examination a poorly fitting crown at the upper right lateral incisor (UR2) was noted. Radiographically, a large periapical area was visible. The patient had no pain and did not proceed with active treatment. The patient presented 12 months later when the crown fractured off leaving the post in the root.

Diagnosis:

Chronic periapical periodontitis associated with a suboptimal root canal filling and fractured post. Adequate tooth structure remained to restore the tooth with a new post crown and 2mm ferrule.

Treatment:

The UR321 were isolated using rubber dam
The fractured post removed with the aid of ultrasonics.
Working length was determined with an apex locator.
Endodontic retreatment was performed with One Curve and Protaper Gold nickel titanium files to clean and shape the canal walls.
Apical patency was maintained throughout with a size 10 Flex-o-File.
A cone fit radiograph verified the canal had been prepared to a good working length
Thorough cleaning was completed with a passive ultrasonic irrigation protocol with 3% hypochlorite and final rinse with 17% EDTA.
Obturation was completed with 40/.06 gutta-percha cone, AH plus sealer and warm vertical compaction.
A new post was prepared, and a provisional crown fabricated and cemented with temp bond.