Nonsurgical management of endodontic iatrogeny using mta plug: A case report

ABSTRACT

Endodontic treatment confronting previous iatrogeny in teeth with incomplete root formation and apical periodontitis is presented as a challenge to the Endodontists. The sanitization and peri-radicular repair can be achieved by the assist of auxiliary materials to biomechanical treatment procedures. MTA is cogitated as a choice for these cases due to its composition, physicochemical, mechanical and biological properties. In this case report, the patient presented tooth 11 with incomplete root formation and peri-radicular radiolucent lesion accompanied by the presence of an inverted gutta-percha cone in an attempt to filling the root canal. Endodontic treatment was accomplished by removal of the previous gutta-percha. After determining the working length, biomechanical preparation was achieved up until #80 K-file. Sequentially application of calcium hydroxide, as intracanal medication, was performed. Six monthly exchanges of intracanal dressing were completed. Apex was sealed with MTA bonded with saline through #4 Paiva condenser, creating an apical plug. The tooth was temporarily sealed, and patient returned after a week to perform the root canal filling with gutta-percha associated to Sealapex. The final radiography shows apical tissue repair with no peri-radicular lesions and clinical signs of successful treatment. This case report highlights the tissue repair and lack of local infection, absence of sensitivity pain or edema. These findings indicated that these approaches could be elect to presence of necrotic lesions achieving tissue repair.