As its material, gutta-percha, polycarboxylic acid cement, zinc phosphate cement, zinc oxide eugenol cement, IRM cement, EBA cement, glass ionomer cement, composite resin and the like have been used. In the event that the root canal system and periodontal tissue are accidentally transported, a sealant is used to protect the teeth. Patient was followed up after oneand ten months later?Figure 11,12? the apical lesion disappeared, and the good prognosis was confirmed.įigure 7: 3D images when patient visited general dentist.įigure 8: Xray image when patient visited department of endodontics.įigure 10: Xray image after root-end restoration using MTA.įigure 11: Xray image after one month of the root-end restoration using MTA.įigure 12: Xray image after ten months of the root-end restoration using MTA.
The dental X-ray showed the wide root apex of the involved tooth and divided roots canal were doubted.?Figure 8? Since the retreatment was difficult for the anatomical problem, root-end restoration was carried out with MTA?Figure 9,10). The 3D image by cone beam CT showed the apical periodontitis with the defect of buccal cortical bone?Figure 7). The sinus tract appeared on the apical gingiva after three years. The mandibular first premolar was treated 5 years ago because of dental caries by a general dentist, and the pulp extirpation was performed. Thirteen months later?Figure 6), the apical healing was confirmed.įigure 1: Xray image when patient visited pediatric clinic.įigure 2: Xray image when patient was treated at the pediatric clinic.įigure 3: Xray image after retreatment and root canal filling.įigure 5: Xray image after root-end restoration using MTA.įigure 6: Xray image after thirteen months of the root-end restoration using MTA.Ĭase 2: A 35-year-old male patient visited to get a second opinion concerning his lower right first premolar. Finally, the retro filling with MTA was applied to the cut root end cavity (Figure 4,5). The retreatment was referred to our clinicafter 10 months and was tried by a common procedure?Figure 3). The root canal treatment was started in the pediatric clinic however, the prognosis was not preferable because of the over extension of calcium hydroxide paste?Figure 2). The tooth was replanted for luxation by a traffic accident when the patient was 9 years old, and external root resorption was revealed at 24 years old?Figure 1).
Although the prognosis was poor with normal root canal treatment, root-end restoration using MTA was performed, and these two cases followed a favorable healing process.Ĭase 1: A 25-year-old male was referred to an endodontic clinic from a pediatric clinic for treatment of external resorption of upper left central incisor tooth. This study reports two clinical cases with informed consent. At our university, it is used only in the example of a patient giving informed consent, based on recognition from Ethical Review Board. At present, the adaptation of MTA in Japan is restricted only to direct pulp capping, and it does not accept to root canal filling, restoration of external resorption, retro filling and closing of perforationon the insured coverage. Mineral Trioxide Aggregate (MTA) is a general material for endodontic treatment and is indicated widely as perforation repair, apexification, pulp capping or root-end filling. Keywords: Mineral Trioxide Aggregate MTA Root-end restoration From these results, it was shown that Root-end restoration using MTA is effective for patients with poor prognosis of root canal treatment for which the apical portion cannot be tightly packed for various reasons. Root-end restoration using MTA was performed on these two cases, and improvement of the lesion was confirmed. The other case is a case where the root canal at the apical part has a complicated anatomical form, the root canal cannot be tightly packed, and the apical lesion has not disappeared. In one case, a large amount of Calcium hydroxide(Ca (OH)2), a intracanal medicament, escaped from a wide-open apex, stagnated around the tooth root, and the apical lesion did not disappear.
Root-end restoration using Mineral Trioxide Aggregate (MTA) was performed on two patients who received root canal treatment but had poor progress.