Conservative Management of a Molar with Separated Instrument and Periapical Lesion: A Two-Year Clinical Follow-Up and Review of Regenerative Strategies

Todorova R, Raykovska M, Nikolova N, Grandini S

Abstract: This case report presents the nonsurgical retreatment of a mandibular molar with a periapical lesion and a retained instrument in the mesiolingual canal. Despite the complexity of the case, a conservative, multi-step protocol including pre-endodontic build-up, advanced instrumentation, ultrasonic irrigation, and bioactive obturation was successfully employed. Over a two-year follow-up period, clinical and radiographic assessments showed significant healing and stable outcomes. The report underscores the regenerative potential of periapical tissues, the value of contemporary bio ceramic sealers, and the necessity of structured monitoring in managing difficult endodontic cases.

Keywords: periapical healing, endodontic retreatment, separated instrument, tricalcium silicate sealer, conservative dentistry

How to Cite?: Todorova R, Raykovska M, Nikolova N, Grandini S, "Conservative Management of a Molar with Separated Instrument and Periapical Lesion: A Two-Year Clinical Follow-Up and Review of Regenerative Strategies", Volume 14 Issue 10, October 2025, International Journal of Science and Research (IJSR), Pages: 1013-1019, https://www.ijsr.net/getabstract.php?paperid=SR251013230639, DOI: https://dx.doi.org/10.21275/SR251013230639