Nonsurgical Removal of Overextended Gutta-Percha Root Canal Filling in a Permanent Maxillary Central Incisor with Apical Root Resorption - A Case Report

ABSTRACT

The goal of endodontic treatment is elimination of microorganisms from the infected root canals and prevention of further infection, which is achieved thorough cleaning and shaping of root canals followed by obturation and an adequate coronal restoration.1 In the event of intraradicular reinfection due to inadequacies of previous treatment, persistence of infection, or reinfection when the coronal seal is lost, retreatment is carried out. Retreatment is mainly based upon the patient’s clinical presentation and compliance, operator’s experience and expertise, the risk of complications, technical and economic feasibility.2 The treatment options could be nonsurgical retreatment, surgical retreatment, combined nonsurgical and surgical or extraction.3Complete removal of gutta-percha from the root canal, re-establishing working length, promoting disinfection and re-obturating the root canal are the main goals of non-surgical retreatment in order to establish healthy periapical tissues.4 Loss of apical constriction due to resorption or over instrumentation often leads to overextension of obturating materials such as gutta-percha (GP) and root canal sealers. Residual GP in the periapical tissues may cause mechanical irritation and inflammation, thereby leading to endodontic failure.5 Most often the overextended GP section is removed by a surgical approach as they may not be amenable to orthograde removal. This case report describes the nonsurgical retreatment of a permanent maxillary central incisor with apically extruded GP.