what is the best solution about this clinical case?

[nessyseggy]

Hello,

I'm a resident in dental surgery and I really don't know what to do abour the following clinical case: a young man who wanna treat his 24, it is fixed to the upper jaw and doesn't move at all, I really wonder about the possibilities for an apical surgery???

Thanks so much!

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[pwhite]

Hi,
Just saw the radiograph you posted and though I'd post my opinion.
I think its a good case for an apicectomy. The tooth seems to be firm in its socket and the patient is young. Would definitely be worth a try. You might want to proceed first by redoing the endodontic treatment. Make sure the canals are cleaned and do very good biomechanics preparation (especially the apical 2/3rds which seems unprepared). Obturate well with GP points and a good sealer with optimum lateral and apical force. Don't worry about over obturating in this case since the apical surrey needs to be done. Make sure there aren't any voids in the obturated canal as that will compromise the success of the entire procedure.
Proceed with the apical curettage preferably on a different date as the root canal treatment. Might want to consider a post core and a crown following. Hope this helps.