Thursday, October 27, 2011
In 2006, #19 was diagnosed as necrotic pulp w/ acute apical periodontitis. An irregular radiolucency was noted on the mesial aspect of distal root. This was diagnosed a resorptive defect. While some may have elected to remove the tooth and place an implant or bridge, this patient wanted to preserve her tooth, so a root canal and root repair was performed.
During our RCT procedure, the resorptive defect was cleaned out without perforation of the root. The appearance of the post-op radiograph appears to show some kind of communication.
At 20 months, the patient returned for recall and a large furcal lesion was present. Once again, more may have elected to extract the tooth and replace it with an implant or bridge. We discussed options/prognosis and decided to retreat and try to repair the resorptive area with MTA.
#19 was retreated and resorptive defect repaired with MTA. You can see the resorptive defect was opened more aggressively and there was extrusion of MTA into the periodontal ligament.
3 year recall (since the retx and repair with MTA) shows complete healing of the furcal lesion. The tooth is fully functional and asymptomatic. This is a tooth was was saved by endodontic therapy using the right material. This tooth was saved by endodontic therapy and the use of MTA to repair and seal the resorptive defect.