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ePaper created 2017-03-17, 10:24:23 | version 1.38.0
Fig. 1 Fig. 2 Fig. 3 Fig. 1 Clinical photograph of the vestibule in the left upper jaw. Note the scar resulting from the previous surgery. Fig. 2 Pre-op radiograph of this unusual case afecting the maxillary left canine. Note the periapical radiolucency around the metal post. Fig. 3 Clinical photograph of the metal ring in the apical third of the root canal. Fig. 4 Intra-op radiograph with the file in the canal. Note the full length of the metal post extruding into the periapical tissue. Fig. 4 nonsurgical endodontic retreatment was suggested to the patient. The tooth was anesthetized, a rubber dam was placed and an access cavity was created in order to reach the root canal. After removal of the old gutta-percha fill- ing material up to the apical third of the root, the endodontic file was unable to progress farther and a solid stop was felt. Exploration of the apical third under an operating microscope was performed. Under high magnification, the presence of a metal ring tightly wedged in the apical part of the canal was seen (Fig. 3). The metal ring was filled with old gutta-percha. The intraoperative radiograph with the file in place revealed the full length of the met- al post extruding into the periapical tissue (Fig. 4). The multiple attempts to remove the metal object via an orthograde ap- proach were unsuccessful. The tooth was medicated with calcium hydroxide and the patient rescheduled for surgery at the next appointment. At the next visit, the patient was anesthe- tized, and under rubber dam isolation, the Article Endodontics issue 2017 — 39