Nice healing of a large peri-apical lesion

A colleague referred a patient for root canal treatment (RCT) on her lower central incisor to me because of the large apical lesion. A tooth with large apical lesion indicates long standing infection of its pulp. Does RCT really work on a tooth that has been infected for many years? If RCT is not successful, then an apical surgery is indicated.

RCT was carried out in the standard manner. The tooth was isolated with a rubber dam and secured with Wedjet because the lower incisor was too tiny to place a clamp over it.

Obturation was carried out after placing calcium hydroxide in the canal for the two weeks. Note the two portal of exits at the apex. A composite restoration was placed.

One year review showed almost resolution of the peri-apical lesion. Hence, apical surgery is not required.