Learning from failure

Trying to save a tooth which is strictly in a bad condition is occasionally a mission for a dentist depending on a patient’s character, dentist’s skill, etc. It is sometimes difficult to make a decision whether the tooth can be saved or is hopeless and should be extracted.

This case was the molar tooth astride the bone defect, only the tips of three roots were hemmed in by remaining bone, which caused loosening a little. It seemed to be challenging to get complete bone fill in this case, because of complexity in shape at the site, which means difficulties of complete debridement before applying bone graft and Emdogain which is medicine for tissue regeneration. During 5 years, it had kept in a better condition after the surgery. However, bone loss and loosening happened in the end. The partial bone fill may be just a happenstance and temporally. In a challenging case, being craven should be avoided, however, eternity of the tooth was delusional as a result. If I encountered the same case, I would apply deferent incision lines and materials. Learning from failure must be kept in mind.

The photos are ,during surgery, X-ray before surgery, 1 year after, 3 years after, 5 years after, 6 years after, respectively.

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