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  • Writer's pictureQuek And Me Dental Surgery

Unraveling the Mysteries of Retrograde Root Canal: A Case Study

Dealing with dental issues can sometimes be a complex journey, as seen in the case involving a patient who presented with complaints of pain in the #13 region. This case not only highlights the importance of timely intervention but also sheds light on the advanced techniques employed in endodontics, specifically the Retrograde Root Canal procedure.

Case Overview:

Upon examination, the patient exhibited buccal and lingual swelling in the #13 region, prompting the use of Cone Beam Computed Tomography (CBCT) for a detailed analysis. The results were revealing—a radicular cyst on #13 had increased in size, measuring at least 12mm x 10mm. The cyst had not only eroded through the buccal and palatal bones but also posed potential involvement of the nasal floor and sinus.

Treatment Options:

Considering the severity of the case, two viable treatment options were presented to the patient:

  1. Enucleating and removing the Radicular Cyst around the #13 apex.

    • Apicoectomy for #13.

    • Retrograde root-fill with Mineral Trioxide Aggregate (MTA) for #13.

2. Extraction of #13, followed by enucleation and removal of the cyst.

After providing a detailed quotation and explaining the associated risks and procedures, the patient opted for the first option. The stage was set for a comprehensive treatment plan aimed at alleviating the patient's pain and addressing the cystic growth.

Treatment Procedure:
  1. Local Anesthetic Infiltration: The patient was administered local anesthesia to ensure a pain-free experience throughout the procedure.

  2. Incision and Flap Elevation: A meticulous incision was made, and a buccal envelope flap was raised, carefully avoiding the gingival margin of teeth and interdental papillae.

  3. Cyst Enucleation: The cyst was dissected and separated from the buccal flap through blunt dissection, and it was successfully removed from the bony defect.

  4. Apicoectomy and Retrograde Root-Fill:

    • An apicoectomy was performed on #13, involving the removal of the apical Gutta-Percha (GP) and cavity preparation.

    • The Retrograde Root-Fill procedure with MTA was then carried out to seal the root apex effectively.


This case serves as a compelling illustration of the intricate challenges that dental practitioners may encounter. The successful implementation of the Retrograde Root Canal procedure underscores the significance of staying abreast of advanced endodontic techniques to ensure optimal patient care. As we continue to explore and refine our methodologies, such cases contribute to the evolving landscape of dental science, offering valuable insights into effective treatments for complex dental conditions.

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