Selective Re-treatment of Distal root

In the past, when we attempted Re-treatment, we used to re-treat all the canals. For the past 4-5 years, I’ve been doing mostly selective Re-treatment ie: treat only those roots or canals which need something to be done. Michael Trudeau calls it “Titrated Treatment”. Some of my friends call it “Image guided Treatment (IGT)”.
This patient had pain followed by a sinus tract on a previously endo treated and crowned mandibular second molar. The Distal root had a lesion. The Mesial root, although short, didn’t have any lesion. So, I decided to leave the mesials alone. I placed Calcium hydroxide, waited for the sinus to heal and then Obturated.

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