Conventional Endodontic Retreatment of Persistent Pain on Previously Treated Tooth in an Elderly Patient: A Case Report

  • Nina Dhaniar Student of Specialist Program of Conservative Dentistry Department, Faculty of Dental Medicine, Universitas Airlangga
  • Hermawan Adi Praja Student of Specialist Program of Conservative Dentistry Department, Faculty of Dental Medicine, Universitas Airlangga
  • Ratih Mahanani Santoso Student of Specialist Program of Conservative Dentistry Department, Faculty of Dental Medicine, Universitas Airlangga
  • Cendranata Wibawa Ongkowijoyo Student of Specialist Program of Conservative Dentistry Department, Faculty of Dental Medicine, Universitas Airlangga
  • Widya Saraswati Lecturer of Specialist Program of Conservative Dentistry Department, Faculty of Dental Medicine, Universitas Airlangga
Keywords: elderly patient, endodontic retreatment, persistent pain, previously treated tooth

Abstract

Clinical evaluation for a successful root canal treatment is assessed by various criteria, which are clinical, histopathological, and radiographical criteria. Therefore, failure of endodontic treatment can be described as a recurrence of clinical symptoms, with the presence of a periapical radiolucency or both. Failure factors in the treatment are frequently related to persistent infection. Conventional endodontic retreatment is indicated for symptomatic previously treated teeth or asymptomatic teeth with inadequately done initial endodontic treatment to avoid potential recurrence. Endodontic retreatment in elderly patients is a great challenge because the clinician has to reassure both the physical and psychological factors of the patient to determine whether to save a tooth or perform an extraction. Some difficulties may also be found in root canal retreatment, including finding the root canal hole or root canal blockage found in parts of the root canal that have not been repaired in the previous treatment.

A 60-year-old female patient came with the chief complaint of recurrent pain, and subjective discomfort in the maxillary left central incisor. The patient had anxiety about the dental treatment. The tooth had a history of root canal treatment four months ago.

The clinical examination showed a positive response to the percussion test. The radiographical analysis showed a root canal underfilling, 2-3 mm short of length from the apex. The tooth was diagnosed as a previously treated tooth with symptomatic apical periodontitis. Endodontic retreatment was performed based on the patient’s clinical condition and consent, followed by composite restoration.

The clinical and radiographic re-evaluation after four weeks of follow-up revealed an excellent condition. This favorable result showed that a conventional retreatment plan of persistent pain on the previously treated tooth in an elderly patient led to progressive healing, and a longer follow-up was advised.

Published
2021-11-24