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 ).
Stomatology Edu Journal
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