Abstract
Background: The success rate of contemporary apical surgery is high after the introduction of magnification, ultrasonics, and bioceramic materials. Persistent apical periodontitis following surgical treatment is usually related to the failure in eliminating or at least sealing residual bacteria occurring in the root canal system.
Case Description: This article reports on a clinical case of postsurgical apical periodontitis associated with a mandibular molar exhibiting failing root-end filling with a bioceramic (calcium silicate-based) material. The tooth had been subjected to retreatment and later to apical surgery because of persistent apical periodontitis. After a period in that the lesions had apparently healed based on radiographs, the appearance of a sinus tract and the observation of recurrence of the apical periodontitis lesions on both roots as shown by CBCT led to indication for a new surgery.
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