iam egyptian dentist&also very difficult case hahaha
this is my story i have upper left 7 which had 2 re-endo treatment the problem everytime pain with percussion&pain without stimulus the diagnosis was periapical lesion but there is no pus no swelling in x-ray only widening on periodontal membrane space with slight radiolucency periapically some professors say it is 2ry apical peridontits
i feel the problem in palatal canal which enlarged to size 110 apex become so large
i did irrigation with sodium hypochloride- hydrogen peroxide -saline
i put ca hydroxide periapically using file&cone there is mild relief but after time pain come back
i use dermatic cream containg steroid&antibiotic also mild releif but pain happen again really i get upset i dont know what to do i feel that my teeth didnt accept endodontic treatment as i have to extract upper 6 before for persistant infection too
there is dentist advising me to make mix from clindamycin&saline &apply it apically
iam afraid of persistant bacterial action
do i have to take biopsy is there any clinical guide to take it in the right way
any idea do u have?
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Can you provide us with xray images?