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Periapical radiolucency appears to involve the teeth #27 and 28. RCT is initiated at #27 through the incisal dimple. The orifice is reached immediately. Occasionally Sodium Hydro chlorite solution seems to leak out of the fistula. After debridement and placement of Ca(OH)2 paste (Fig.4 *) in the canal, the fistula is apparently shrunken (data not shown). The patient is scheduled to return 1 month.
In fact the apex of the tooth #27 is open (Fig.3). Debridement of the canal should be 1-2 mm from the X-ray apical foramen to prevent paste escape.
Xin Wei, DDS, PhD, MS 1st edition 02/14/2018, last revision 05/26/2018