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Tooth associated with Persistent apical periodontitis
Functional retention of the tooth : persistent lesion while remain asymptomatic function for an extended period of time .
-Patient's goal is to retain his tooth without pain, it may not need to complete healing , but follow up .
- Uncertain healing : if sign or symptoms of persistent infection ( progressive enlarging periapical radiolucency , periodontal pocket formation , sinus tract )
- Further retreatment is needed.
- To determine that the case has persistant periapical periodontitis, we should determine the function of the tooth and the healing is it proper or not.
- We should do complete evaluation to the case before start treatment " determine if the tooth is restorable or not, can I remove obturating material or not "
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Once the decision has been made to retain the tooth there are two ways for ttt: • Non surgical retreatment : - guided access to apex via coronal access
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