Selective Re-treatment /IGT/ Titrated Treatment

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 on a previously endo treated and crowned mandibular second molar. CBCT showed a missed mesio-lingual canal. I decided to Re-treat the Mesio-buccal canal as well because the CBCT scan showed that the missed mesio-lingual canal merged with the mesio-buccal canal apically.

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