NONSURGICAL MANAGEMENT OF ENDODONTIC IATROGENY USING MTA PLUG: A CASE REPORT

Abstract

Endodontic treatment confronting previous iatrogeny in teeth with incomplete root formation and apical
periodontitis is presented as a challenge to the Endodontists. The sanitization and peri-radicular repair can be
achieved by the assist of auxiliary materials to biomechanical treatment procedures. MTA is cogitated as a
choice for these cases due to its composition, physicochemical, mechanical and biological properties. In this
case report, the patient presented tooth 11 with incomplete root formation and peri-radicular radiolucent lesion
accompanied by the presence of an inverted gutta-percha cone in an attempt to filling the root canal.
Endodontic treatment was accomplished by removal of the previous gutta-percha. After determining the
working length, biomechanical preparation was achieved up until #80 K-file. Sequentially application of
calcium hydroxide, as intracanal medication, was performed. Six monthly exchanges of intracanal dressing
were completed. Apex was sealed with MTA bonded with saline through #4 Paiva condenser, creating an apical
plug. The tooth was temporarily sealed, and patient returned after a week to perform the root canal filling with
gutta-percha associated to Sealapex. The final radiography shows apical tissue repair with no peri-radicular
lesions and clinical signs of successful treatment. This case report highlights the tissue repair and lack of local
infection, absence of sensitivity pain or edema. These findings indicated that these approaches could be elect
to presence of necrotic lesions achieving tissue repair.