Badria Almatrafi*, Reem AlIdrisi, Hussein Mukhles, Hisham Zaidan, Abdulmajeed Altakhees, Waffa Albusais, Mawaheb Alharbi, Amal alshehri, Saud Alsaif, Norah Alotaibi, Mshael Almohaimel
Endodontic therapy aims to eliminate diseased pulp tissue and effectively seal the root canal system to prevent reinfection. However, failures can occur if the therapy deviates from established standards. This case report highlights an endodontic mishap involving a missing isthmus, a critical anatomical feature that can compromise treatment success. A 38-year-old female presented with discomfort in the lower right area of her mouth related to an endodontically treated tooth. Despite a wellobturated root canal, Symptomatic Apical Periodontitis (SAP) persisted. Exploratory surgery revealed a missing apical isthmus associated with the mesial canal. An apicoectomy was performed, and the isthmus was sealed with MTA. The case underscores the importance of identifying and addressing isthmus presence to improve treatment outcomes. Modern microsurgical techniques, including the use of magnification and biocompatible materials, are effective in managing such complexities, demonstrating high success rates in long-term follow-ups.
Published Date: 2025-02-21; Received Date: 2023-10-04
