Question

A patient has a draining sinus tract apical to a maxillary lateral incisor. The tooth, which is restored with a post and crown, received a root canal filling and apicoectomy one year ago. Radiographically, the tooth measures 19 mm. in length. Adjacent teeth respond normally to pulp testing. The patient is asymptomatic. Which of the following is the most acceptable treatment?

A. Retreat and refill the canal with gutta-percha.
B. Retreat and refill the canal, then perform an apicoectomy.
C. Retreat by surgery using a retrofill amalgam.
D. No treatment is necessary unless the patient develops symptoms.

Answer 1

The most acceptable treatment for the patient described would be to retreat and refill the canal with gutta-percha, as this may resolve the residual infection and heal the sinus tract.

Step-by-step explanation:

The most acceptable treatment for a patient with a draining sinus tract apical to a maxillary lateral incisor, which had a root canal and apicoectomy one year ago, would be A. Retreat and refill the canal with gutta-percha. Since the adjacent teeth are responding normally to pulp testing and the patient is asymptomatic, this suggests that the previous treatments have failed to resolve the issue. Retreating the root canal means removing the old gutta-percha, cleaning the canals thoroughly, and refilling them with new gutta-percha. This should resolve any residual infection and encourage healing of the sinus tract.