PMC5093245_01
(a) Preoperative IOPA, (b) unintentional extrusion of MTA from apical foramen, (c) 1-month follow-up, (d) 3-month follow-up, and (e) 6-month follow-up.
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fig1
Radiographically, tooth #12 showed periapical rarefaction measuring approximately 2 mm (width) x 4 mm (height), with a resorbed apex (Figure 1(a)). Radiograph taken during the procedure displayed considerable extrusion of the MTA into the periradicular tissues (Figure 1(b)). On the 1-month recall visit, the patient reported no episodes of discomfort and/or swelling (Figure 1(c)). Periapical radiographs taken at 3- and 6-month recall visits to evaluate the periapical condition showed slight resorption of the MTA which was extruded into periapical area (Figures 1(d) and 1(e)).
PMC5093245_02
(a) Preoperative IOPA, (b) unintentional extrusion of MTA from apical foramen, (c) 1-month follow-up, (d) 3-month follow-up, and (e) 6-month follow-up.
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fig2
Radiographic examination revealed open apex of tooth #21 associated with a large periapical lesion of about 8 mm in diameter (Figure 2(a)). Tulsa Dental Specialities, Johnson City, TN, USA) apexification was performed as described in Case 1. Despite adequate precautions ensured during MTA placement, there was some extrusion of MTA (Figure 2(b)) into the periapical tissues. The patient was kept under observation for any signs or symptoms of clinical discomfort. The patient was scheduled for follow-up at 1- and 3-month intervals (Figures 2(c) and 2(d)). Thereafter, at 6-month recall, a decrease in size of the periapical radiolucency was noted on periapical radiograph (Figure 2(e)).
PMC5093245_03
(a) Preoperative IOPA, (b) unintentional extrusion of MTA from apical foramen, (c) 1-month follow-up, (d) 2-month follow-up, (e) 3-month follow-up, and (f) 6-month follow-up.
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fig3
Evaluation of periapical radiographs showed a large radiolucent lesion with well-defined margins around the root of tooth #11 along with an open apex and root resorption (Figure 3(a)). MTA apexification was performed as described earlier, but unintentionally a considerable amount of MTA was seen to have extruded into the periapical region, when checked on periapical radiograph (Figure 3(b)). At the one-month follow-up appointment (Figure 3(c)), the tooth was asymptomatic. The 3- and 6-month follow-up periapical radiographs showed gradual healing of the periapical lesion along with resorption of the MTA (Figures 3(e) and 3(f)).