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ePaper created 2017-03-17, 10:24:23 | version 1.38.0
Discussion The present case report has demonstrat- ed that sometimes an approach combin- ing both orthograde and surgical treat- ment is required in order to treat previously endodontically treated teeth and to provide a long-term favorable out- come. The decision to proceed surgically or nonsurgically is sometimes determined by the intraoperative conditions. It should be noted that CBCT was not available to the clinicians at the time of the surgery. Nowadays, preoperative examination using CBCT provides valuable information for the diagnosis and treatment of end- odontically compromised teeth. Further- more, the case report has shown that the microsurgical approach under the high magnification of the operating micro- scope, together with the use of dedicated ultrasonic tips and biocompatible materi- al, was crucial for the long-term success of the treated tooth. Fig. 15 Post-op radiograph. Fig. 16 The condition of the soft tissue immediately before suture removal. Fig. 17 Radiographic control three years after surgery. Note the good reapposition of the bone and the reforma- tion of the lamina dura around the amputated root. Fig. 18 Soft-tissue control three years after surgery. Note the esthetic healing of the soft tissue. Teeth #22 and #23 presented with new cervical fillings. Fig. 19 Radiographic control ten years after surgery. The tooth had maintained a stable bone condition and no apical radiolucency was visible. Fig. 20 Soft-tissue control ten years after surgery. Fig. 16 Fig. 18 Fig. 15 Fig. 17 Fig. 19 Fig. 20 42 — issue 2017 Endodontics Article