02/06/2026
Perfed, now non-restorable
So, a patient came in with tenderness around #9 in August 2022, obvious PARL, tenderness to percussion. I recommended RCT and thought I could do it. Rx: AMX and told her to come back ASAP. She scheduled for the next week.
Access wasn't a problem. But then I was having some trouble negotiating the canal. Eventually got to a length similar to what I expected based on pre-op radiographs. But I couldn't get a dry canal. Place CaOH and had her come back to obturate another day.
Obturation went ok. She had some soreness afterwards, but otherwise recovered quickly and had no other issues. Until April. Follow-up xray at a hygiene visit looks really off. So I refer her to endo.
Got a call today from the endodontist and he's gentle, but basically says I shouldn't be doing endo anymore because of how bad I perforated this tooth and now there's not facial bone remaining. And the tooth is non-restorable and needs an implant. Also #10 might need a root canal (he hadn't tested vitality yet).
I guess I'm wondering if he's right. I know that I'm supposed to be able to deliver care up to the standard of an endodontist, and without a CBCT I didn't recognize how off I was. I've read a lot of other dentists here wondering if they're really cut out for the job, and now I'm in that boat. I've had tons of other root canals go fine, but this looks really rough. Thoughts anyone?