Retrograde Treatment With Bioceramic Sealers: A Case Report

A 53-year-old female presented with severe percussion pain and radiographic periapical lucency associated with a maxillary canine supporting a prosthodontic bridge. Clinical tests and CBCT revealed pulp necrosis and an S-shaped canal curvature with a periapical lesion. Removal of the post and core, followed by orthograde endodontic treatment, carries a significant risk of root fracture during post removal. Such a complication could lead to tooth loss, which would compromise occlusal guidance and esthetic harmony. Moreover, replacing the lost canine with an implant would prevent its use as a joint abutment with a natural tooth, as implant-to-tooth-supported bridges are biomechanically unfavorable. These potential complications underscore the need for conservative and alternative treatment approaches in preserving the canine. In this case, retrograde application of a bioceramic sealer achieved predictable sealing and favorable periapical healing in a tooth with complex canal anatomy and a crucial place, supporting bioceramic materials as effective alternatives to traditional retro-filling agents in selected surgical endodontic cases.