title: Endodontic re-treatment associated with the elimination of amalgam root-end filling through sinus tracts: a report of two cases.
abstract: Two patients presented with complaints of recurrent drainage of purulent exudate from sinus tracts, inflammation and pain after endodontic re-treatment of the maxillary left (Case 1) and right (Case 2) lateral incisors. The periapical lesions persisted after apical curettage, apicectomy and root-end filling with silver amalgam. Radiographic examination exposed the poor quality of the endodontic treatments and the silver amalgam root-end fillings, which were associated with periapical radiolucent areas in both teeth. The sinus tract persisted after root canal cleaning and shaping, followed by a calcium hydroxide root canal dressing. The root-end fillings were periapically dislodged with endodontic K-files, and showed progressive displacement by sinus tracts up to elimination in the oral cavity. Follow ups of 42 and 65 months post procedure revealed clinical disappearance of the symptoms, sinus tracts and exudates, and radiographs revealed that the repair process of the periapical radiolucent areas was quite advanced.
authors.affiliation: Department of Dentistry, Federal University of Jequitinhonha and Mucuri Wales, Diamantina, Minas Gerais, Brazil.
authors.forename: Janir Alves
authors.initials: JA
authors.lastname: Soares
authors.forename: Eduardo
authors.initials: E
authors.lastname: Nunes
authors.forename: Frank Ferreira
authors.initials: FF
authors.lastname: Silveira
authors.forename: Suelleng Maria Cunha
authors.initials: SM
authors.lastname: Santos
authors.forename: Maiolino Thomaz Fonseca
authors.initials: MT
authors.lastname: Oliveira
mesh_terms: D000328:Adult; D001047:Apicoectomy / Q000379:methods; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D003723:Dental Amalgam / Q000009:adverse effects*; D003751:Dental Fistula / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications; D005260:Female; D006801:Humans; D007180:Incisor / Q000473:pathology / Q000601:surgery; D008437:Maxilla; D010482:Periapical Abscess / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D019233:Retreatment; D012387:Root Canal Filling Materials / Q000009:adverse effects / Q000627:therapeutic use*; D012389:Root Canal Obturation / Q000009:adverse effects / Q000379:methods; D014092:Tooth Root / Q000473:pathology / Q000601:surgery*; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D012387:Root Canal Filling Materials; D003723:Dental Amalgam; D002126:Calcium Hydroxide