ENDODONTIC RETREATMENT USING MTA-BASED SEALANTS IN A TOOTH WITH PERFORATION AND PERIAPIAL LESION: A CLINICAL CASE REPORT
Figure 1. Initial Radiography. Figure 2. A. Initial aspect of the perforation; B. Aspect after placement of MTA HP Repair.
Case Reports
Figure 3. Radiographic aspect after the placement of MTA HP Repair in the perforation.
Figure 4. Odontometrics radiography. Figure 5. Product used for sealing the perforation- MTA HP Repair Sealant( Angelus Indústria de Produtos Odontológicos) A. Powder capsule; B. Liquid( distilled water).
Figure 6. Figure 6. Manipulation of MTA HP Repair reparative sealant. A. Powder; B. Liquid; C. Insertion with MTA instrument.
also features high success rates in pulp capping, pulpotomy, apical barrier formation in open apices and root perforation repair. 6 The purpose of this clinical case report was to report an endodontic retreatment with presence of root perforation in the furcation region, in which reparative cement and filling sealant based on mineral trioxide aggregate( MTA) were used.
2. Clinical Case Report A female patient came to the dental office complaining of pain, for retreatment of element 36. Radiographically, it presented thickening of the periodontal ligament and periapical lesion in the mesial and distal roots, leading to the diagnosis of chronic apical periodontitis( Fig. 1). Through radiographies with angulation to mesial and distal it was possible to check the presence of 4 canals. In the first session, the following actions were performed: a crown opening, location of the canals and removal of the filling material with an
ultrasound flat tip Irrisonic( Helse Dental Technology, São Paulo, Brazil). After 3 days, the patient returned and with an operative microscope it was possible to locate the perforation in the most cervical portion in the furcation region in the mesio vestibular root, which was covered by red resin( Fig. 2A). Intra canal medication based on calcium hydroxide( Biodinâmica Química e Farmacêutica, Paraná, Brazil) and a saline solution were used. In the next session, the deviation in the mesio canal was filled with MTA HP Repair( Angelus Indústria de Produtos Odontológicos, Paraná, Brazil) and glass ionomer( S. S. White Duflex, Rio de Janeiro, Brazil) to enable performing the instrumentation of canals avoiding the expansion of the perforation( Fig. 3). In the same session, the remaining gutta-percha present in the distal canal was removed, electronic odontometrics was performed, and the tooth received calcium hydroxide intra canal medication( Biodinâmica Quimica e Farmacêutica, Paraná, Brazil).
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