Treatment of Apical Root Resorption Using Mineral Trioxide Aggregate: Case Report

Year 2015, , 58 - 62, 01.01.2015

Neslihan Yılmaz Ersan Çiçek Mustafa Murat Koçak

https://doi.org/10.21306/jids.2015.1.11

Abstract

The root canal infection which routes a natureway in the apical direction can initiate the inflammation of periapical tissues following pulp necrosis. This process stimulates the destruction of periapical tissues and the loss of tooth structures. This condition clinically occurs as an inflammatory apical root resorption. This case report presents the treatment of mandibular first molar tooth with severe inflammatory apical root resorption using MTA. In this case, the size of apical root resorption was determined with using CBCT. In the treatment; following the root canal disinfection procedures, the distal canal with apical root resorption was obturated with MTA and other canals were obturated with gutta-percha and AH26 using cold lateral compaction technique. In the six months follow-up; the resorption had stopped and the periapical lesion had healed with bone-like hard tissue. In conclusion; with careful clinical procedures, proper disinfection and repair material, successful non-surgical treatment for apical root resorption is possible

Keywords

Root resorption, MTA, CBCT

Apikal Kök Rezorpsiyonunun Mineral Trioksit Agregat Kullanılarak Tedavisi: Olgu Sunumu

Abstract

Pulpa nekrozundan sonra, apikal yönde doğal bir yol izleyen kök kanal enfeksiyonu periapikal dokuların inflamasyonunu başlatabilmektedir. Bu süreç periapikal dokuların yıkımını ve diş yapılarının kaybını stimüle edebilmektedir. Bu durum klinik olarak inflamatuar apikal kök rezorpsiyonu olarak gözlenmektedir. Bu olgu sunumu şiddetli inflamatuar apikal kök rezorpsiyonu bulunan alt birinci molar dişin mineral trioksitagregat MTA ile tedavisini sunmaktadır. Bu olguda apikal kök rezorpsiyonunun boyutu konik ışınlı bilgisayarlı tomografi CBCT ile tespit edilmiştir. Tedavisinde kök kanal dezenfeksiyon işlemleri uygulandıktan sonra apikal kök rezorpsiyonu izlenen distal kök kanalı MTA, diğer kanallar ise güta-perka ve AH26 kullanılarak lateral kompaksiyon yöntemiyle doldurulmuştur. 6 aylık takip sonunda rezorpsiyonun durduğu ve periapikal lezyonun kemik benzeri sert doku oluşumu ile iyileştiği görülmüştür. Sonuç olarak uygun olarak yapılan endodontik tedavi işlemleri, yeterli dezenfeksiyon ve doğru tamir materyali ile apikal kök rezorpsiyonunun cerrahisiz tedavisinin başarılı olabileceği gözlenmiştir

Keywords

Kök rezorpsiyonu, MTA, CBCT

References

• 1. Tronstad L. Root resorption-etiology, terminology and clinical manifestations. Endod Dent Traumatol 1988; 4: 241-252.
• 2. Nance RS, Tyndall D, Levin LG, Trope M. Diagnosis of external root resorption using TACT (tuned-aperture computed tomography). Endod Dent Traumatol 2000; 16: 24-28.
• 3. Pierce A. Pathophysiological and therapeutic aspects of dentoalveolar resorption. Aust Dent J 1989; 34: 437-448.
• 4. Gunraj M. Dental root resorption. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 647-653.
• 5. Andreasen FM, Sewerin I, Mandel U, Andreasen JO. Radiographic assessment of simulated root resorption cavities. Endod Dent Traumatol 1987; 3: 21-27.
• 6. Delzangles B. Apical periodontitis and resorption of the root canal wall. Endod Dent Traumatol 1988; 4: 273-277.
• 7. Laux M, Abbott PV, Pajarola G, Nair PN. Apical inflammatory root resorption: a correlative radiographic and histological assessment. Int Endod J 2000; 33: 483-493.
• 8. Cvek M. Treatment of non-vital permanent incisors with calcium hydroxide. II. Effect on external root resorption in luxated teeth compared with the effect of root filling with gutta-percha. A follow-up. Odontol Revy 1973; 24: 343-354.
• 9. Sjögren U,Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the out come of endodontic treatment of teeth with apical periodontitis. Int Endod J 1997; 30: 297-306.
• 10. Siqueira JF, Rôças IN, Ricucci D. Biofilms in endodontic infection. Endod Top 2010; 22: 33-49.
• 11. Ricucci D, Siqueira JF. Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings. J Endod 2010; 36: 1277-1288.
• 12. Siqueira JF, Rôças IN, Lopes HP. Patterns of microbial colonization in primary root canal infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 93: 174-178.
• 13. Trope M. Root resorption due to dental trauma. Endod Top 2002; 1: 79-100.
• 14. Laux M, Abbott PV, Pajarola G, Nair PN. Apical inflammatory root resorption: a correlative radiographic and histological assessment. Int Endod J 2000; 33: 483-493.
• 15. Liao J, Al Shahrani M, Al-Habib M, Tanaka T, Huang GT. Cells isolated from inflamed periapical tissue express mesenchymal stem cell markers and are highly osteogenic. J Endod 2011; 37: 1217-1224.
• 16. Cooper PR,Takahashi Y, Graham LW, Simon S, Imazato S, Smith AJ. Inflammation-regeneration interplay in the dentine-pulp complex. J Dent 2010; 38: 687-697.
• 17. Patel S, Dawood A. The use of conebeam computed tomography in the management of external cervical resorption lesions. Int Endod J 2007; 40: 730-737.
• 18. Ren H, Chen J, Deng F, Zheng L, Liu X, Dong Y. Comparison of cone-beam computed tomography and periapical radiography for detecting simulated apical root resorption. Angle Orthod 2013; 83: 189-195.
• 19. Estrela C, Bueno MR, De Alencar AH, Mattar R, ValladaresNeto J, Azevedo BC, De Araújo Estrela CR. Method to evaluate inflammatory root resorption by using conebeam computed tomography. J Endod 2009;35:1491- 1497.
• 20. Hashiguchi D, Fukushima H, Yasuda H, Masuda W, Tomikawa M, Morikawa K, Maki K, Jimi E. Mineral trioxide aggregate inhibits osteoclastic bone resorption. J Dent Res 2011; 90: 912-917.
• 21. Thesleff I, Sharpe P. Signalling networks regulating dental development. Mech Dev 1997; 67: 111-123.
• 22. Rakian A, Yang WC, Gluhak-Heinrich J, Cui Y, Harris MA, Villarreal D, Feng JQ, Macdougall M, Harris SE. Bone morphogenetic protein-2 gene controls tooth root development in coordination with formation of the periodontium. Int J Oral Sci 2013; 5: 75-84.