Case of the week part 20.

I love to see such a healing progress in such difficult case. PT came to my office with pain on percussion of tooth 46. Initial RVG shows that tooth was already RCT and have big lesion nearby apex of medial root. It also shows that probably there is zip in apical part of medial canals, and apical surgery will be the option. I decided to try reendo - two visit approach with calcium hydroxide in between. I had huge problems during shaping protocol - no apical patency both in messiahs and distal one. I used a lot of hypo, US, and citric acid. Then I obturate. Third RVG is one year recall -despite technical problems lesion is gone!!!! You don't always need a patency to properly clean root canals!