Application of High-Frequency Conduction for Persistent Apical Periodontitis: A Case Report

2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Toshihiko Tominaga ◽  
◽  
Eiichiro Tada ◽  
Kazuki Takahira ◽  
Tsutomu Sugaya ◽  
...  
Keyword(s):  
Root Canal ◽  
High Frequency ◽  
Root Resorption ◽  
Root Surface ◽  
Apical Periodontitis ◽  
Root Canal Filling ◽  
Tissue Inflammation ◽  
External Root Resorption ◽  
Ultrasonic Irrigation

We report the case of a 39-year-old male with Persistent Apical Periodontitis (PAP) caused by infection in an uninstrumented area, wherein conventional chemical root canal treatment is not possible, which was sterilized via highfrequency conduction. He underwent root canal filling after multiple endodontic treatments for tooth #4. As symptoms recurred, he was referred to our department with the chief complaint of dull pain during mastication. Present symptoms were percussion pain of the tooth, buccal mucosa swelling at the apical portion, and grade 1 mobility. Radiography revealed inadequate root canal filling. A radiolucent image 5×6 mm in diameter and with an unclear boundary was observed around the apex. External root resorption was mainly observed in the apical foramen, with a crown root ratio of approximately 1:1. Using 6% sodium hypochlorite under dental microscopy, chemomechanical root canal preparation was performed. Passive ultrasonic irrigation and calcium hydroxide application were conducted three times; however, periapical tissue inflammation did not subside. Therefore, the patient was diagnosed with PAP, and the uninstrumented area was sterilized via high-frequency conduction. High-frequency currents were applied to the apex, root surface, and periapical lesion at 500 kHz and 90 V; periapical tissue inflammation resolved after 2 weeks. Subsequently, the root canal was filled. Follow-up radiography revealed a bone regeneration-like image at 2 months. Bone defects healed at 11 months. Although surgical endodontic therapy is conventionally performed in PAP patients, high-frequency conduction could be a minimally invasive nonsurgical endodontic treatment option for uninstrumented areas in PAP patients.

scholarly journals Severe Root Resorption after Obturating a Primary Molar Using Zinc Oxide and Eugenol at Different Follow-up Periods – A Case Report

2020 ◽  
Vol 8 (C) ◽  
pp. 99-100
Author(s):  
Mona Abdel Rehim Wahby ◽  
Sherine Ezz Eldin Taha ◽  
Eman Sayed El Masry ◽  
Randa Youssef Abd Al Gawad
Keyword(s):  
Zinc Oxide ◽  
Case Report ◽  
Root Canal ◽  
Root Resorption ◽  
Primary Molars ◽  
Filling Material ◽  
Root Canal Filling ◽  
Primary Molar ◽  
External Root Resorption

AIM: The aim of this study is to present severe root resorption following obturation of the primary molar with zinc oxide eugenol (ZOE) at different follow-up periods. CASE REPORT: We present the case of a 6-year-old boy with decayed lower primary molars. Pulpectomy for pulpally involved primary molars was performed. ZOE has been used as root canal filling material and follow-up was done at 3, 6, and 9 months. CONCLUSION: External root resorption was detected at 3 months and the resorptive process continued till 9 months. This finding emphasizes the need for alternative filling material with less irritating properties.

scholarly journals Healing of a tooth with an overinstrumented apex, extensive transportation and periapical lesion using a 5 mm calcium hydroxide apical plug: an 8-year follow-up report

2012 ◽  
Vol 23 (5) ◽  
pp. 608-611
Author(s):  
Ronaldo Araújo Souza ◽  
Yara T. Corrêa Silva-Sousa ◽  
Suely Colombo ◽  
Maurício Lago ◽  
Marco Antonio Hungaro Duarte ◽  
...  
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Filling Material ◽  
Root Canal Filling ◽  
Apical Constriction ◽  
Gutta Percha ◽  
Open Apices ◽  
Canal Transportation

Besides the risk of filling material extrusion throughout the apex, a satisfactory apical seal can be difficult to achieve in canals with open apices or iatrogenic enlargements of the apical constriction. These situations pose a challenge to root canal filling. This paper describes the root canal filling of a maxillary right canine with an overinstrumented apex, complete loss of the apical stop, extensive canal transportation and apical periodontitis. A 5 mm calcium hydroxide apical plug was placed before root canal filling. The plug was made by soaking paper points with saline, dipping the points in calcium hydroxide powder and then applying it to the apex several times, until a consistent apical plug was obtained. The canal was then irrigated with saline in order to remove any residual calcium hydroxide from the root canal walls, dried with paper points and obturated with an inverted #80 gutta-percha cone and zinc oxide-eugenol based sealer by the lateral condensation technique. An 8-year radiographic follow-up showed formation of mineralized tissue sealing the apical foramen, apical remodeling and no signs of apical periodontitis.

scholarly journals Outcome of Root Canal Treatment of Necrotic Teeth with Apical Periodontitis Filled with a Bioceramic-Based Sealer

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Kawther Bel Haj Salah ◽  
Sabra Jaâfoura ◽  
Mahdi tlili ◽  
Marwa Ben Ameur ◽  
Saida Sahtout
Keyword(s):  
Treatment Group ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Root Canal Treatment ◽  
Inclusion Criteria ◽  
Root Canal Filling ◽  
Radiographic Findings ◽  
Periapical Lesions ◽  
Single Cone

Introduction. Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods. This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session treatment group. All cases were obtured with BioRoot using a single-cone technique with a minimum of a 6-month recall. At 6-month follow-ups, teeth were classified as healed, healing (success), or not healed (failure), based on clinical and radiographic findings. Results. Twelve patients met the inclusion criteria, six patients per group. Seven patients returned for follow-ups. At 6-month follow-ups, the overall success rate was 100%, with 57.1% determined to be “healed” and 42.8% determined to be “healing.” All the PAI scores decreased compared to the baseline situation. Conclusion. The results obtained showed the contribution of BioRoot RCS in the healing of periapical lesions. Accordingly, bioceramic-based sealers seem to optimize the prognosis of root canal treatments.

scholarly journals Nonsurgical Endodontic Retreatment of Advanced Inflammatory External Root Resorption Using Mineral Trioxide Aggregate Obturation

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Shivani Utneja ◽  
Gaurav Garg ◽  
Shipra Arora ◽  
Sangeeta Talwar
Keyword(s):  
Root Canal ◽  
Root Resorption ◽  
Clinical Symptoms ◽  
Mineral Trioxide Aggregate ◽  
Radiographic Examination ◽  
Apical Region ◽  
Central Incisor ◽  
Root Canal Filling ◽  
Maxillary Central Incisor ◽  
External Root Resorption

Inflammatory external root resorption is one of the major complications after traumatic dental injury. In this case report, we describe treatment of a maxillary central incisor affected by severe, perforating external root resorption. An 18-year-old patient presented with a previously traumatized, root-filled maxillary central incisor associated with pain and sinus tract. Radiographic examination revealed periradicular lesion involving pathologic resorption of the apical region of the root and lateral root surface both mesially and distally. After removal of the root canal filling, the tooth was disinfected with intracanal triple antibiotic paste for 2 weeks. The antibiotic dressing was then removed, and the entire root canal was filled with mineral trioxide aggregate. The endodontic access cavity was restored with composite resin. After 18 months, significant osseous healing of the periradicular region and lateral periodontium had occurred with arrest of external root resorption, and no clinical symptoms were apparent.

scholarly journals Management of Traumatic Inflammatory External Root Resorption

2019 ◽  
Vol 15 (1) ◽  
pp. 71-74
Author(s):  
Shikha Bantawa ◽  
Navin Agrawal ◽  
Mannu Vikram ◽  
Vimmi Singh ◽  
Ashok Ayer ◽  
...  
Keyword(s):  
Root Canal ◽  
Root Resorption ◽  
Clinical Symptoms ◽  
Mineral Trioxide Aggregate ◽  
Radiographic Examination ◽  
Apical Region ◽  
Dental Tissue ◽  
Root Canal Filling ◽  
Gutta Percha ◽  
External Root Resorption

Inflammatory external  root resorption is one of the major complications after traumatic dental injury. It is characterized by the loss of mineralized dental tissue which may, ultimately, result in loss of the tooth.    However, with appropriate treatment, prognosis for these teeth may be greatly improved, by preventing or arresting resorption. This is a case report of an 18-year-old male patient presented with root canal treated maxillary central incisors associated with pain; with history of trauma. Radiographic examination revealed periradicular lesion and associated pathologic resorption of the apical region of the root with respect to 11 and calcification of the root canal with inadequate obturation with respect to 21. After removal of the root canal filling, 11 was disinfected with intracanal double antibiotic paste. After 2 weeks, antibiotic dressing was removed, and apical third was sealed with mineral trioxide aggregate (MTA). Canal was obturated with custom-fit gutta-percha and accessory cones with AH plus sealer and restoration was done with composite resin. Retreatment was also done with respect to 21 and obturated with custom-fit gutta-percha. Both teeth were restored with E-max crown. No clinical symptoms were apparent, significant osseous healing of the periradicular region was observed with arrest of external root resorption with respect to 11 and no periapical changes were apparent with respect to 21 on subsequent  follow-up.

Reabsorção externa inflamatória após luxação intrusiva dentária – conduta clínica de tratamento tardio

2020 ◽  
Vol 12 (45) ◽  
pp. 113-117
Author(s):  
Caroline Felipe Magalhães Girelli ◽  
Thaís da Silva Alves ◽  
Betina Maria de Lima Oliveira ◽  
Mariane Floriano Lopes Santos Lacerda ◽  
Carolina Oliveira de Lima
Keyword(s):  
Clinical Picture ◽  
Root Canal ◽  
Clinical Case ◽  
Root Resorption ◽  
Treatment Plan ◽  
Root Surface ◽  
Endodontic Treatment ◽  
Radiographic Examination ◽  
Dental Office

External inflammatory root resorption (EIRR) is one of the consequences of pulp necroses caused by intrusive dislocation (ID). The objective of the study was to report a clinical case of ID associated with EIRR, which was submitted to late endodontic treatment. Patient came to the dental office five months after a trauma with a clinical picture of intrusive dislocation of tooth 21 associated with pulp necrosis, but without symptoms. Radiographic examination showed an image compatible with EIRR along root surface. The treatment plan was to undergo endodontic treatment with calcium hydroxide changes which occurred monthly for 8 months. When EIRR stopped, the root canal was filled. After clinical and radiographic follow up for 5 years, there was an involution of the damage caused by the clastic activity resulting from the resorptive process, characterizing the success of the instituted therapy.

scholarly journals Respuesta del ligamento periodontal a la avulsión dental. Reporte de caso / Periodontal Ligament Response to Dental Avulsion. Case Report

2017 ◽  
Vol 35 (75) ◽  
Author(s):  
Raúl Solórzano Santos ◽  
Antonio José Díaz-Caballero ◽  
Eduardo Covo Morales
Keyword(s):  
Case Report ◽  
Periodontal Ligament ◽  
Root Resorption ◽  
Root Surface ◽  
Permanent Teeth ◽  
Traumatic Lesion ◽  
External Root Resorption ◽  
Type K ◽  
Dental Avulsion

RESUMEN. Antecedentes: La avulsión es un tipo de lesión traumática poco frecuente en la dentición permanente. La reabsorción radicular externa es un evento común posterior al reimplante de un diente avulsionado. Objetivo: Reportar un caso de trauma de dos dientes reimplantados, en el que se obtuvieron resultados satisfactorios con 26 semanas de seguimiento. Reporte del caso: Manejo clínico de paciente de sexo masculino de 8 años de edad que se presenta a la clínica del Postgrado de Endodoncia de la Universidad de Cartagena, Colombia, con antecedente de avulsión y posterior reimplante con ferulización de los dos incisivos centrales superiores. Los dientes fueron preparados hasta lima 50 tipo K, medicados con hidróxido de calcio y obturados con MTA. Resultados: Se observó cicatrización de la superficie radicular con disminución de las zonas de reabsorción externa radicular después de 26 semanas de seguimiento. Conclusión: La reabsorción radicular externa en dientes avulsionados reimplantados puede contrarrestarse en la medida que hayan sido manejados con conocimiento profesional, dentro de un marco de tiempo y condiciones biológicas.  ABSTRACT. Background: Dental avulsion is a rare traumatic lesion in permanent teeth. External root resorption is a common event after reimplantation of an avulsed tooth. Purpose: To report a case of two reimplanted teeth with satisfactory results after controls during 26 weeks. Case report: Clinical management of an 8-year-old boy that seeks attention in the clinic of the Postdoctoral Program in Endodontics of University of Cartagena with background of avulsion of both central upper incisors. The teeth were prepared up to a type K # 50 file, medicated with calcium hydroxide and later filled with MTA. Results: Healing was observed on the root surface with reduction of the external radicular resorption after a 26-week follow-up. Conclusion: External radicular resorption can be counteracted as long as its handling was performed professionally within parameters of time and biological conditions.   

scholarly journals Non-Surgical Endodontic Management of External Root Resorption in a Permanent Maxillary Central Incisor Tooth - A 3 Year Follow-Up of a Rare Case Scenario

2021 ◽  
Vol 10 (30) ◽  
pp. 2350-2353
Author(s):  
Kothandaraman Sathyanarayanan ◽  
Lingeswaran Poornima ◽  
Keerthi V. Narayan
Keyword(s):  
Surgical Management ◽  
Root Canal ◽  
Root Resorption ◽  
Signs And Symptoms ◽  
Central Incisor ◽  
Partial Loss ◽  
Incisor Tooth ◽  
Tooth Structure ◽  
External Root Resorption

Resorption of the tooth represents a multifactorial and a perplexing problem for all clinicians resulting in complete or partial loss of tooth structure. The present clinical demonstration describes management of the permanent maxillary left central incisor (tooth number #21) affected by external root resorption involving the mesial and distal surface of middle one-third of the root. Conventional nonsurgical endodontic treatment followed by MTA (Mineral trioxide aggregate) obturation (PRoRoot MTA, Dentsply, Tulsa Dental Specialties) was planned. The root canal of the affected teeth was debrided with Dual Rinse HEDP (Medcem Weinfelden, Switzerland) containing etidronate powder and chemomechanical preparation of the root canal was performed with XP endo shaper file system (FKG Dentaire, SA, Switzerland). Thirtysix months’ post-operative follow-up revealed complete healing of the external root resorption defect with no clinical and radiological signs and symptoms. In the present case simple non-surgical endodontic management of severe external root resorption was done in a permanent maxillary tooth by using a continuous chelation irrigation technique, intracanal medicament followed by obturation with bio-ceramic material produced satisfactory results in contrast to the recommended surgical management. Resorption of the tooth being a multifactorial and a perplexing problem for all clinicians results in complete or partial loss of tooth structure. According to the Glossary of Endodontic terms, Resorption is defined as a condition associated with either a physiologic or a pathologic process resulting in the loss of dentine, cementum, and/or bone.1 Traditionally resorption can present either as internal or as external resorption.2 External root resorption occurs on the outer surface of the root and are of dissimilar nature such as external surface resorption, external inflammatory root resorption, ankylosis, and external replacement resorption, the most common being external inflammatory root resorption.3 According to the Glossary of Endodontics, “Inflammatory resorption is defined as an internal or external pathologic loss of tooth structure and possibly bone, resulting in a defect; occurs as the result of microbial infection; characterized radiographically by radiolucent areas along the root”.1 It may result due to dental trauma, forceful orthodontic tooth movement, long standing infection of the pulp or periodontal tissues. External resorption presents as a major resorptive condition of the root without any clinical signs and symptoms.2 The non-surgical management of external inflammatory root resorption is based on its aetiology, which needs to be eliminated

scholarly journals Endodontic Management of a Tooth with Severe External Root Resorption using Injected Non-setting Calcium Hydroxide Paste: A Case Report

2020 ◽  
Author(s):  
Orlando Aguirre Guedes ◽  
Tiago Luan Henrique ◽  
Pollyana Sousa Lôbo El Zayek ◽  
Andreza Maria Fábio Aranha ◽  
Helder Fernandes De Oliveira
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Root Resorption ◽  
Pathological Condition ◽  
Cold Test ◽  
Apical Periodontitis ◽  
Radiographic Examination ◽  
Root Canals ◽  
External Root Resorption ◽  
Composite Resin Restoration

External Root Resorption (ERR) is a pathological condition that can lead to tooth loss if not diagnosed and treated correctly. Calcium Hydroxide Ca(OH)2 is an intracanal medicament, which is used in cases of teeth with pulp necrosis, peri-radicular lesions and ERR. This paper describes the endodontic management of a tooth with severe ERR using injected non-setting Ca(OH)2 paste. A 28-year-old patient was referred for endodontic evaluation of tooth 47, which presented an extensive composite resin restoration and was negative to cold test. Panoramic and periapical radiographs revealed the presence of a filled pulp chamber, calcified root canals, ERR on the mesial and distal roots, and apical periodontitis in the mesial and distal roots. The diagnosis of asymptomatic apical periodontitis and severe ERR was established, and conventional root canal treatment combined with non-setting Ca(OH)2dressing was chosen. After five months, no more discharge from the root canal was observed, and a decrease in the size of the periapical lesion and arrest of ERR was detected. The root canal was filled, and the patient was referred for restoration. At the 6-months follow-up, radiographic examination evidenced periapical repair and containment of the ERR process. Chemomechanical root preparation in association with a non-setting Ca(OH)2 dressing protocol allows positive outcomes during the management of severe ERR associated with pulp necrosis and periapical inflammation.

scholarly journals External Inflammatory Root Resorption: Management of a Tooth with hopeless Prognosis

2017 ◽  
Vol 2 (1) ◽  
pp. 24-27
Author(s):  
K Shoba ◽  
R Abhilash ◽  
Jithin Balan ◽  
MR Sreelakshmi
Keyword(s):  
Management Strategy ◽  
Root Resorption ◽  
Correct Diagnosis ◽  
Root Surface ◽  
Cone Beam ◽  
Collagen Membrane ◽  
Effective Management ◽  
Maxillary Central Incisor ◽  
External Root Resorption

ABSTRACT The treatment of external root resorption and associated periodontal defect can be challenging to the most ingenious clinician. A correct diagnosis and an understanding of the etiology and dynamics of root resorption, which is the progressive loss of dentin and cementum through action of osteoclastic cells, are critical for effective management. The article describes the management of an external root resorption in maxillary central incisor where a combined endo-perio management strategy was implemented. Cone beam computed tomography was used as an adjunctive diagnostic aid. A combined approach using biodentine for root surface repair, bone graft, collagen membrane, and platelet-rich fibrin to address the associated osseous lesion appears to be viable modality in treatment of the same. After a follow-up period of 12 months, the patient was found to be asymptomatic. Postoperative radiographs also demonstrated satisfactory bone fill and arrest of the resorptive lesion. How to cite this article Abhilash R, Balan J, Shoba K, Sreelakshmi MR. External Inflammatory Root Resorption: Management of a Tooth with hopeless Prognosis. Cons Dent Endod J 2017;2(1):24-27.

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