Question

A 35-year-old woman completed root canal treatment two years ago on the maxillary right second premolar illustrated in the radiograph. The patient now complains of "pain over the gum." Clinical examination reveals that the tooth is painful to percussion. Which of the following is the best treatment for this patient?

A. Extract the tooth.
B. Retreat the root canal.
C. Perform an apical curettage.
D. Perform an apicoectomy and a retrofill.
E. Place the patient on a 10-day course of antibiotics, then re-evaluate for the next course of treatment.

Answer 1

The best treatment for the woman with post-root canal pain would likely be to retreat the root canal to address any potential treatment failure or infection without resorting to tooth extraction or more invasive surgeries.

Step-by-step explanation:

The 35-year-old woman who completed root canal treatment on the maxillary right second premolar and is now experiencing pain over the gum is likely suffering from a post-treatment complication, such as failed root canal or possible infection. Given that the patient presents with pain to percussion, the best treatment options involve addressing the potential causes directly at the source. The options include retreatment of the root canal (Option B) or surgical intervention, such as apicoectomy and retrofill (Option D). Simply extracting the tooth (Option A) without considering its salvageability or placing the patient on a 10-day course of antibiotics and then re-evaluating (Option E) may not address the underlying issue if there is a persistent endodontic infection or failure. An apical curettage (Option C) is less commonly performed for such indications. Among the options, retreating the root canal would potentially address any failed initial treatment or further infection without immediately resorting to extraction or more invasive surgical procedures.