Although most silver points treated teeth in the 60’s, 70’s, and the occasional case in the early 1980’s have already been retreated or extracted, there are some cases that are still functional and in the patients’ mouth. Occasionally, these cases fail due to coronal leakage and primarmily due to recurrent decay or old, leaking restoration. The leakage results into an apical infection since the apical leakage is usually present due to the use of ZOE based sealers to cement such cones that were resorbable and washed out of the canals after a certain amount of time.
This tutorial demonstrates such case. Due to decay that was at one point repaired on the buccal aspect of the crown in a silver point treated tooth #5, the apex was failing and a periapical radiolucency with an associated sinus tract was present. The patient was originally referred for apicoectomy; however, apicoectomy in such cases has a poor long term success since the source of the lesion is the unaddressed coronal leakage.
This tutorial shows the retreatment of such cases through the crown. A new crown is always needed following successful retreatment given the original leakage.