title: Surgical management of a failed internal root resorption treatment: a histological and clinical report.
abstract: This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.
authors.affiliation: Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Asgary
authors.affiliation: Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Jafar
authors.initials: MJ
authors.lastname: Eghbal
authors.affiliation: Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Leili
authors.initials: L
authors.lastname: Mehrdad
authors.affiliation: Department of Craniofacial Biology, School of Dental Medicine, University of Colorado Denver, Aurora, CO, USA.
authors.forename: Sanam
authors.initials: S
authors.lastname: Kheirieh
authors.affiliation: Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Nosrat
keywords: CEM cement; Calcium enriched mixture; Extrusion; Mineral trioxide aggregate; Perforation; Root resorption