Journal of Dental School

Vol. 44 No. 1 (2026)

Combined Nonsurgical and Surgical Endodontic Management of an Affected Maxillary First Molar In a 14 Year-Old Patient: A Case Report

Journal of Dental School, Vol. 44 No. 1 (2026), 29 December 2025 , Page e12
https://doi.org/10.22037/jds.v44i1.50546

Abstract

Objective(s): This report aimed to illustrate the advantage of a hybrid endodontic treatment protocol—integrating orthograde retreatment with subsequent microsurgery—to resolve persistent endodontic failure in permanent molar of a growing patient, thereby preventing premature extraction. Case: A 14-year-old male was referred with a chronic apical abscess and a persistent sinus tract related to the maxillary right first molar (#16). Initial management involved conventional orthograde retreatment; however, the periapical pathology failed to resolve after a three-month observation period. Consequently, endodontic microsurgery was initiated. The surgical protocol incorporated the employment of a high power dental operating microscope, ultrasonic retro-tips, and retrofilling with a bioactive ceramic (Cold Ceramic), supplemented by guided tissue regeneration (GTR). Subsequent clinical and radiographic evaluations at one, six, and 12 months confirmed complete osseous regeneration and resolution of symptoms. Conclusion: For adolescent patients where implants are contraindicated due to incomplete skeletal development, endodontic microsurgery offers a predictable strategy for retaining natural dentition.

Keywords:
  • Endodontic surgery
  • Magnification
  • Microsurgery
  • Osteotomy
  • Posterior region

How to Cite

Naqi Beiranvand, M., Zandi, B., & Maddah, S. T. (2026). Combined Nonsurgical and Surgical Endodontic Management of an Affected Maxillary First Molar In a 14 Year-Old Patient: A Case Report. Journal of Dental School, 44(1), e12. https://doi.org/10.22037/jds.v44i1.50546

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