PMC3530227_01
(a) Preoperative periapical radiograph showing periapical lesion and external apical and lateral root surface resorption in a maxillary left central incisor. The radiograph also reveals previous poor quality obturation. (b) Radiograph after removal of old gutta percha filling showing root canal outline completely visible through resorption defect. Bone resorption adjacent to resorption lacunae on root is also evident. (c) Working length radiograph. (d) Immediate postobturation radiograph showing adequate density of MTA obturation without voids and good adaptation of MTA to root contours. (e) Six-month followup periapical radiograph revealing stability of resorption and periapical healing. (f) Advanced osseous healing of periapical tissues and initiation of repair adjacent to lateral root surface resorption at 12 months. (g) An 18-month radiographic view showing complete regeneration of periradicular tissues and advanced osseous healing evident in the lateral periodontal tissues.
CRIM.DENTISTRY2012-624792.001.jpg
PMC3530227_01_CRIM.DENTISTRY2012-624792.001.jpg
fig1
The root canal space of 21 was inadequately obturated (Figure 1(a)). A radiograph taken to ensure complete removal of gutta percha showed uneven radiolucent regions along the external borders of the root, and the outline of original root canal was completely visible (Figure 1(b)). Working length was determined radiographically (Figure 1(c)), and canal preparation was accomplished in a circumferential filing motion using H files while irrigating with copious amount of 1% sodium hypochlorite (Novo Dental Products Pvt. MTA was adequately compacted into the resorption defect with good adaptation to the root contours (Figure 1(d)). Moist cotton pellet was kept in the chamber, and the access cavity was sealed with a temporary restorative material. There was initiation of osseous healing adjacent to mesial and distal resorption sites on the root surface (Figures 1(e), 1(f), and 1(g)).