PMC3548344_01
(a) Preoperative radiograph showing internal resorption in tooth #8 of a 49-year-old female patient, (b) Obturation of the canal and resorptive defect using the warm vertical compaction technique
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F2
Tooth #8 on a periapical radiograph revealed a well delineated oval enlargement of the pulp space in the apical third of the root, which was continuous with the root canal walls [Figure 2a]. At the next appointment, the Ca(OH)2 paste was flushed out; the canal was dried and obturated with warm vertical compaction technique using gutta-percha [Figure 2b].
PMC3548344_02
(a) Perforating internal resorptive defect in tooth #10 of a 31-year-old male patient, (b) Sectional cone gutta-perchaobturationin the apical third of canal, (c) Repair of resorptive defect with MTA
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F3
An oval radiolucency indicative of internal resorption was evident in the middle third of the radicular portion of tooth #10 [Figure 3a]. The canal was dried and sectional cone obturation with gutta- percha was carried out in the apical third of canal [Figure 3b]. The resorptive defect was then repaired with Mineral trioxide Aggregate (MTA) [Figure 3c].
PMC3548344_03
(a) Tooth #9 showing internal replacement resorption and external root resorption in a 27-year-old male patient. Radio opaque metaplastic tissue seen in the canal space, (b) Deviation of the negotiating file towards the mesial aspect, (c) Uneven flow of calcium hydroxide paste due to the presence of metaplastic tissue, (d) Scrapping off the metaplastic tissue using an H-file, (e) Even flow of the medicament, (f) Obturation of teeth # 9 and 10 using gutta-percha
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F4
The pulp canal space of tooth #9 appeared enlarged and exhibited the presence of a less radiopaque material partially obscuring the continuity of the canal space while tooth #10 displayed total obliteration of the canal space [Figure 4a]. Following access cavity preparation, canal space of tooth #9 was negotiated and the radiograph revealed the deviation of the file towards the mesial aspect [Figure 4b]. But a periapical radiograph displayed an uneven flow of the intracanal medicament, confirming the presence of metaplatic tissue [Figure 4c]. Hence, the Ca(OH)2 was flushed out of the canal and the metaplastic tissue was scrapped off the canal with the aid of hand H-files [Figure 4d] providing an unhindered flow of the medicament [Figure 4e], which was refreshed at regular intervals of 15 days. Pulp canal space of tooth #10 was negotiated at a later appointment and the endodontic therapy of both the teeth was completed in next few scheduled visits [Figure 4f].