SURGICAL ENDODONTIC APPROACH TO A MAXILLARY CENTRAL INCISOR WITH A SUPERNUMERARY ROOT

Abstract

Incisor on cone beam computed tomography (CBCT), a surgical endodontic operation using a surgical operating microscope (SOM) was performed. On dental radiographic examination, CBCT showed the presence of a supernumerary root, and the disto-eccentric projection showed a sinus tract on the mesio-labial side. The tooth itself showed signs of life, although there was a periodontal pocket on the labial side 5-mm deep only near the sinus tract. An X-ray with a gutta-percha point inserted into the sinus tract showed that it went to the apex of the supernumerary root. This showed that the main root canal was not connected to the supernumerary root, and that only the supernumerary root was dead. Therefore, using the SOM, it was possible to resect and remove only the dead supernumerary root and to keep the living tooth in good condition for five years even without a pulpectomy. When used together in surgical endodontic treatment, CBCT and SOM are therefore shown to be effective for examination, diagnosis, and treatment.