Apical capping as a new technique for retrograde treatment of an infected root apex: introduction and first results.
BACKGROUND
The success rate of surgical retrograde treatment of an infected root apex is limited by the existence of infected side canals which are not treatable by conventional retrograde preparation and filling techniques. This experimental study introduces a new technique of retrograde apex preparation followed by covering the apex with a titanium cap.


METHODS
In 10 extracted canines, retrograde circular preparation of the root apex was performed using a new ultrasonic preparation tip and a high-power ultrasound machine. The prepared stump was covered by a titanium cap fixed with glass ionomer cement. The teeth were examined clinically and radiologically for unevenness, steps or clefts in the border between the titanium cap and root surface. Furthermore, a histological work-up was performed to register the existence and number of side canals, as well as their covering by the titanium cap and the width of the cement layer.


RESULTS
The clinical and radiological examinations revealed only a small degree of unevenness in one case. In all other teeth the border was without any unevenness. There were 0 - 4 side canals as noted in the histological cross sections, all of which were covered by the titanium cap. The mean width of the cement layer was 27.2microm. From a technical point of view there were no difficulties or complications.


METHODS
For demonstration of the clinical use, a case of a 32-old-patient with an apical cyst on an upper lateral incisor is reported. The patient was treated successfully by apical capping.


CONCLUSIONS
Apical capping is a new technique for retrograde treatment of an infected root apex which seals all side canals effectively. The technique is easy to perform and can be carried out quickly without complications. The technique is suitable for clinical testing.
Gaggl
Alexander
A
Department of Oral and Maxillofacial Surgery, Central Hospital/LKH Klagenfurt, Klagenfurt, Austria. Alexander.Gaggl@lkh-klu.at
Weiglein
Andreas
A
Kahr
Helmuth
H
Chiari
Friedrich M
FM
D000328:Adult; D002484:Cementation; D003481:Cuspid / Q000473:pathology; D003764:Dental Materials; D003786:Dental Pulp Cavity / Q000473:pathology*; D003788:Dental Pulp Diseases / Q000628:therapy*; D005899:Glass Ionomer Cements; D006801:Humans; D007180:Incisor / Q000473:pathology; D008297:Male; D008439:Maxillary Diseases / Q000628:therapy; D011842:Radicular Cyst / Q000628:therapy; D012184:Retrograde Obturation / Q000295:instrumentation / Q000379:methods*; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods; D013499:Surface Properties; D014025:Titanium; D019227:Tooth Apex / Q000473:pathology*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods
D003764:Dental Materials; D005899:Glass Ionomer Cements; D014025:Titanium