Retreatment of a Crowned Tooth

Patient Name

Gender

Male

Doctor Name

Dr. Samay P. Chavan

Acquired Diseases

Retreatment of a Crowned Tooth with Post & Core Build-up and Periapical Lesion

Case Background

A male patient in his thirties presented with a gum boil near a crowned tooth in the lower jaw. Although there was no severe pain, he reported occasional discomfort and a persistent bad taste, particularly in the mornings — classic symptoms suggestive of a chronic underlying infection.

Clinical Findings

Upon examination, an intraoral sinus tract was observed adjacent to a previously root canal-treated tooth. The tract was non-tender but discharged pus on slight pressure. The crown appeared intact externally.

Endodontist in jabalpur dr. Samay premsingh chavan at apollo jbp hospitals

Dr. Samay Premsing Chavan

Endodontist & Root Canal Specialist

Radiographic Analysis

Radiographs revealed:

Previously treated root canal with poorly filled canals
A periapical radiolucency, indicating chronic apical periodontitis
No signs of root fracture or perforation

These findings confirmed the failure of the initial root canal, most likely due to incomplete disinfection or persistent bacterial infection.

Diagnosis

Previously root canal-treated tooth with full crown
Chronic apical periodontitis with sinus tract and periapical lesion
Indication for non-surgical endodontic retreatment
Retreatment of a crowned tooth with post & core build-up and periapical lesion

Treatment Protocol

– The existing crown was carefully removed for canal access.
– The old filling was fully removed to allow re-cleaning and re-instrumentation.
– Calcium hydroxide was used as an interim antibacterial dressing to control infection and promote healing.
– After infection resolution, canals were well obturated, and a post and core composite build-up was done for strength.
– A new custom-fabricated crown was placed, restoring both function and aesthetics.

Clinical Outcome

The sinus tract healed completely after medicament therapy.
The patient reported no further discomfort.
Follow-up radiographs indicated early periapical healing.
The new crown ensured long-term stability and protection of the treated tooth.

Key Takeaways

Intraoral sinus tracts often signify chronic infection from a failing root canal.
Effective retreatment requires complete removal of previous fillings and rigorous disinfection.
Calcium hydroxide remains a vital medicament for eliminating residual bacteria.
Proper post, core, and crown restoration ensures durability and aesthetics.

Conclusion

This case exemplifies how a previously treated, crowned tooth with chronic infection can be successfully salvaged through precise diagnosis, systematic retreatment, and advanced restorative techniques. The result — a fully functional and aesthetically restored tooth, demonstrating Apollo Hospitals Jabalpur’s commitment to excellence in endodontic care.

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Address: Global Square, Patan Rd, Karmeta, Jabalpur. Madhya Pradesh 482002

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