PMC3934391_01
Clinical photograph showing draining sinus in relation to 31 and 32.
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fig1
Talon's cusp with deep foramen caecum (not interfering with occlusion) [Figures 1 and 2]. The vitality test showed that the teeth was non vital.
Clinical picture showing the talons cusp with foramen ceacum in relation to 32.
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fig2
Talon's cusp with deep foramen caecum (not interfering with occlusion) [Figures 1 and 2]. The vitality test showed that the teeth was non vital.
Initial radiograph showing DI type II with immature apex in relation to 32 and periradicular lesion associated with 31 and 32.
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fig3
A diagnostic periapical radiograph revealed that 32 presented with dens in dente type II with immature apex and periapical radiolucency of approximately 15 mm x 20 mm extending distal to the root tip of tooth number 31 [Figure 3].
Radiograph showing GP cone pointing to the involvement of 31 and 32.
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fig4
Endodontic treatment of the involved teeth (31 and 32) was the plan of treatment [Figure 4].
Radiograph showing the whole removal of parts of invagination and rudimentary canal in relation to 32 and metapex dressing in 31.
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fig5
Then complete elimination of invagination was done with the aid of a K-Flex #80 file [Figure 5].
Radiograph reveals working length determination of 31 and 32.
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fig6
After establishing optimal working length in the radiograph of 31 and 32, the canal was disinfected with 5.25% sodium hypochlorite [Figure 6].
Radiograph showing apical plug of 4 mm MTA in relation to 32 and master cone in 31.
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fig7
An apical barrier of 4 mm in thickness was created with Pro Root MTA (Dentsply Tulsa Dental Company) in 32 and it was left with a cotton pellet moistened with distilled water for 48 hours [Figure 7].
Root canal of 31 and 32 obturated with GP along with GIC lining in relation to 32 (dentinal wall) and completed healing of PA tissues.
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fig8
After 2 months of dressing with metapex, 31 were obturated with the help of gutta-percha points [Figure 8].