Endodontic Microsurgery of #5 ❌. Patient came in when she was in her temporary bridge complaining of a bump on her gum, I didn’t see anything at the time and recommended placing the permanent bridge, follow up and then surgery can be an option if sinus tract came back. Sure enough, sinus tract came back after a few months. Two fiber posts made surgery more of a reasonable option. #5 PT/CAA. After resection, no isthmus can be detected after staining, so I did two separate retropreps. 6 mo follow up, shows some radiographic healing and the patient is asymptomatic. Lit review: in apical microsurgery, teeth with isthmus-present had 6 times more failure than teeth with isthmus-absent (Kim 2016). https://instagram.com/p/BqKcg5ulnLC/