Worth an Endo consult or straight to Implant ?

If the RCT is 10-15 years old I would extract vs retreat, the 15mm buccal dehiscence is strongly suggestive of a fracture. What is going on with the second molar furcation area?

I think enough has been invested in this tooth, poor prognosis whatever you try. I think I'd ext and get rid of that infection, then come back in seven weeks and graft or if you are comfortable the place implant and graft simultaneously.

It's gone. Why invest another $1500-$2500 on a very poor prognosis tooth. That kind if money, in my area, almost pays for the whole implant, post, and crown.

extract, but only because of the broken file.

So this case was retreated (non surgically)and healed completely with 1-2 mm probing depths within 8 months! Have pictures and Radiographs but don't know how to post !

Not worth the tome, effort or money, go for the socket preservation and later implant. cheers

Amen to extraction. Retreatment and long term prognosis very bad.

Agree with previous posts. Extract, remove infected tissue, allow to heal, bone graft, allow to heal, place implant. It's not simple but it's predictable.

My comment might sound completely obnoxious..... but an opinion is only an opinion. Years ago, when implants were unheard of and not being done.....every tooth was precious, and if we could not safe an entire tooth, then we would save a part of a tooth...hence we had hemisected molars supporting bridges very nicely...for years on end. In this case, the roots are nicely spread apart.... if the patient is willing to try something a little different....what could be done is to extract the tooth......providing it does not fracture upon removal, then retrograde apicoectomies could be done to each root, while you are holding the tooth in your hand wrapped in a piece of gauze soaked n sterile saline, gently plane the root surfaces. The socket is curreted, washed with citric acid, and rinsed with saline. Prior to starting this procedure, draw two vials of whole blood and centrifuge for 12 minutes, and place the retrieved Platelet Rich Fibrin clot into the socket and the tooth replanted back in its socket. You have created a natural implant.... the PRF is excellent as being pleuripotential, and can stimulate regrowth of the periodontal ligament. I used to do this sort of thing more than 35 years ago with good results, when we did not have PRP or PRF.... the tooth would become solid again, and the pathology would disappear.......what did happen on occasion is that the body would regard the replanted tooth as a foreign body and begin to resorb it...but this could take years...so if your patient is willing..... go for it.... it is very inexpensive, and will cause no damage, and it will preserve the bone. Gerry Rudick Montreal, Canada

extract and curette the area completely and then immediate implant

it seems very clear that the tooth is hopeless , I guess due to fracture or crack at root or bifurcation. anyway in new rct if you expand the canals you will have frcture in the future for sure. so..... extraction and implant etc.... good luck

I would suggest extraction as the tooth is associated with alot of problems. Most probably its a cracked tooth, separated instrument, large buccal defect, radiolucencies around mesial and distal roots. Completely curette the site and wait for six months before you place an implant.

Flap less extraction -disinfection-immediate implant-bone graft-use the existing PFM to make screw retained temporary. Px has solid furcation bone...very easy immediate case. You can get 50 -60 N torque. It must be done. No cuts, no sutures, only one Motrin next day. Awesome.

straight to implant