Selective retreatment of external apical inflammatory resorption with Mineral trioxide aggregate (MTA) in a mandibular first molar with five root canals: A case report

Maraş E., Pertek Hatipoğlu F., Köse T. E.

14th IFEA World Endodontic Congress, Glasgow, İngiltere, 12 Eylül 2024 - 14 Eylül 2025, (Yayınlanmadı)

  • Yayın Türü: Bildiri / Yayınlanmadı
  • Basıldığı Şehir: Glasgow
  • Basıldığı Ülke: İngiltere
  • Recep Tayyip Erdoğan Üniversitesi Adresli: Evet

Özet

Aim: The aim of this report is to present the successful retreatment of external apical inflammatory resorption in relation to the mesial root of a previously treated mandibular first molar with five root canals with periapical lesions.

Summary: 20-year-old male patient was referred complaining of severe pain associated with his mandibular first molar. After radiographic examination, deep caries and large periapical radiolucency in both roots was detected. Under rubber dam isolation, an access cavity was prepared and a third middle root canal was found between the mesiobuccal and mesiolingual root canals. The canals were obturated after calcium hydroxide medication for two weeks. Six months later, a significant reduction in periapical lesion sizes was observed. At 12 months recall, despite the tooth being asymptomatic, a periapical radiograph showed an increase in size of the periapical lesion in the mesial root. Cone-beam computed tomography (CBCT) results showed external apical inflammatory resorption in the mesial root along with the total healing in the distal root. Subsequently, selective canal retreatment was decided. The previous gutta-percha filling in the mesial root was removed by using ProTaper Universal retreatment files (Dentsply Maillefer, Ballaigues, Switzerland) and Hedstrom files (Dentsply Maillefer). Following chemomechanical instrumentation, all mesial canals were filled with BIOfactor MTA (Imicryl, Konya, Türkiye). The restoration was completed by resin composite. After 16 months, the tooth was asymptomatic and radiographic examination revealed complete healing of the periapical lesion.

Key learning points

·       Despite the tooth is asymptomatic and the periapical lesion sizes decrease in short-term follow-ups, long-term radiographic follow-ups should be continued.

·       MTA is an effective treatment material in cases of external apical root resorption due to its capacity to promote hard tissue formation and inhibit osteoclastic bone resorption.

·       Selective root canal retreatment can be considered an appropriate treatment option when CBCT is used as a diagnostic tool.

Keywords: Cone‐beam computed tomography, External apical inflammatory resorption, Mandibular first molar, Mineral trioxide aggregate, Selective root canal retreatment