PMC8314973_01
Periapical radiograph of the #1.7 showing the presence of a periapical radiolucency.
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F1
Periapical radiographs revealed the absence of periapical lesion and a physiological periodontal ligament space [Figure 1].
Cone-beam computed tomography view of the teeth showing a peculiar anatomy of the mesial root near the distal one and without the presence of the buccal cortical bone in the apical region.
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F2
A small periapical radiolucency could be observed at the apex of the distal root [Figure 2].
Clinical view before apical resection showing overfilling.
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F3
After a careful removal of the inflammatory lesion, out of the mesiobuccal root apex, more than 1 mm of the plastic carrier used for the obturation was clearly visible [Figure 3].
Clinical view after root-end management.
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F4
Tulsa Dental, Tulsa, OK, USA) was used as the root-end filling material [Figure 4]. The reflected tissues were then replaced into their original position and sutured with a nonresorbable 4-0 suture (Ethicon Inc., Piscataway, NJ, USA).
(a) Immediate postoperative periapical radiograph. (b) Periapical radiograph after 1 year showing periapical healing. (c) Periapical radiograph after 4 years confirms periapical healing. w. Further periapical radiograph after 8 years underlined periapical healing.
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F5
The 48-month follow-up showed the resolution of spontaneous pain, the absence of other pathological signs and symptoms, and the radiographic resolution of the lesions, confirmed at 8 years follow-up [Figure 5].
PMC8314973_02
Preoperative periapical radiograph.
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F6
In this case, periapical radiograph and CBCT images showed endodontic overfilling without periapical radiolucency [Figures 6 and 7].
Cone-beam computed tomography view showing the presence of radio-opaque overfilling.
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F7
In this case, periapical radiograph and CBCT images showed endodontic overfilling without periapical radiolucency [Figures 6 and 7].
Clinical view showing the presence of a capsulated inflammatory reaction.
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F8
Following flap elevation, a capsulated lesion was visible in correspondence of the apex of #2.5 [Figure 8].
Clinical view after the curettage of the lesion showing the evidence of extrusion of the plastic carrier.
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F9
After a careful removal of the lesion, it was clearly visible more than 1 mm of the plastic carrier of a carrier-based root canal obturation technique extruded [Figure 9].
Apical sealing removing the excess of the carrier and burning gutta-percha.
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F10
Using a hot burnisher with a small round head, the extraradicular carrier was cut, and the gutta-percha was compacted [Figure 10].
(a) Periapical radiograph after 1 year showing good periapical healing. (b) Periapical radiograph after 4 years confirms periapical healing.
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F11