title: 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.
abstract: 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.
authors.affiliation: Graduate Department, Dental School, University of Ribeirão Preto, SP, Brazil. ronaldosouza.endo@gmail.com
authors.forename: Ronaldo Araújo
authors.initials: RA
authors.lastname: Souza
authors.forename: Yara T Corrêa
authors.initials: YT
authors.lastname: Silva-Sousa
authors.forename: Suely
authors.initials: S
authors.lastname: Colombo
authors.forename: Maurício
authors.initials: M
authors.lastname: Lago
authors.forename: Marco Antonio Hungaro
authors.initials: MA
authors.lastname: Duarte
authors.forename: Jesus Djalma
authors.initials: JD
authors.lastname: Pécora
mesh_terms: D000328:Adult; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D003763:Dental Leakage / Q000628:therapy*; D003790:Dental Pulp Necrosis / Q000628:therapy*; D006801:Humans; D008297:Male; D010485:Periapical Periodontitis / Q000628:therapy*; D012389:Root Canal Obturation / Q000379:methods*; D019227:Tooth Apex / Q000473:pathology
chemical_list: D002126:Calcium Hydroxide