PMC5852926_01
(a) A preoperative photograph of tooth 12 showing discolored tooth 12 with a defect at cervical third region (arrow). (b) A preoperative radiograph suggestive of obliterated coronal pulp chamber and enlarged space and concomitant calcific depositions with middle-third of root canal (arrow). (c) The axial section at the level of middle-third of root reveals internal root resorption (arrow). (d) The sagittal section revealed a resorptive defect with concomitant radiopaque deposition
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F1
Clinical examination revealed discolored maxillary right lateral incisor tooth 12 with a defect at a cervical third region [Figure 1a]. The coronal pulp chamber was obliterated and middle third of root canal presented with enlarged space and concomitant calcific depositions [Figure 1b]. CBCT analysis (Kodak 9500 Cone Beam 3D system, USA) of tooth 12 was done using field of view 5 x 5 and axial, sagittal, and horizontal sections were obtained [Figure 1c-d].
(a) The instrument had hooked itself into the canal because of tunneling of the canal. (b) Separated file fragment at the middle third of the canal. (c) Instrument bypassed the separated file fragment. (d) Retrieval of separated file fragment. (e) Biodentine was used to obturate complete root canal system. (f) A 2-year follow-up establishes initiation of periapical healing. (g) A 5-year follow-up establishes significant periapical healing. (h) A photograph after prosthetic rehabilitation
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F2
IOPA revealed that the instrument had hooked itself into the canal because of tunneling of the canal [Figure 2a]. In an attempt to withdraw the instrument, it got separated at the middle-third of the canal [Figure 2b]. After a few attempts, the instrument did bypass the separated file fragment [Figure 2c]. This was confirmed again with a radiograph [Figure 2d]. The vertical condensation pressure extruded the BD material beyond the confines of root canal which was although undesirable, but the patient was asymptomatic during and after the treatment [Figure 2e]. On a 2-year and 5-year follow-up, respectively, periapical healing was evident [Figure 2f-g]. Prosthetic rehabilitation was done following the successful results [Figure 2h].