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RO0211

20 I I case report _ retreatment _Endodontics is all about preservingthenatural dentition. There is no better implant than the natural tooth, given the fact that it can be treated and restored effectively and predictably. Many factors, such as root perforation, affect the prognosis of endodontic treatment.1 Today, perforations can be managed predictably with the use of MTA cement as sealing material.2 Thepurposeofthisarticleistoillustratetheendo- dontic retreatment of a mandibular first molar with perforation in the coronal third of the mesiolingual rootcanal,aidedbytheuseofmagnificationprovided by the dental operating microscope (OM). _Case report A 61-year-old male patient, with a non-contribu- torymedicalhistory,wasreferredbyageneraldentist forretreatmentofamandibularfirstmolar.Thetooth was tender to percussion. Peri-apical radiolucency was evident in both roots and the furcation area. Apreviousroot-canaltreatmenthadbeenperformed morethantenyearsago.Thecanalfillingwasshortin length and the remains of a screw post were present in the mesiolingual canal (Figs. 1 & 2). The treatment plan was to restore the tooth with a cast dowel and porcelain-fused-to-metal (PFM) crown. After local anaesthesia had been administered, a rubber dam was placed and the temporary filling removed.Thefragmentedpostwasremovedbymeans of ultrasonic tips under magnification (G6, Global Surgical). Owing to the vicinity of the post to the furcation,carewastakennottoremovedentinedistal tothepost.Theroot-fillingmaterialapicalofthepost and from the orifices of the other root canals was also removed with ultrasonic tips. Observation under high magnification revealed a small perforation of theroot-canalwallwherethepostwasplaced(Fig.3). The patient and the referring dentist were informed thatthetoothwastoberetreatedandtheperforation defect sealed with MTA cement (DENTSPLY Maillefer). A copious amount of irrigation (2.5% NaClO) was usedthroughoutthetreatment.Therootcanalswere roots2_2011 Retreatment of a lower molar Author_ Dr Konstantinos Kalogeropoulos, Greece Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6