Wednesday, March 5, 2014

Case 16 Anterior tooth with internal resorption repaired with MTA

Pre-operative x-ray showing internal resorption
No history of trauma according to the patient. The tooth was asymptomatic.  Patient was not aware of the problem until it was picked up on by the general dentist doing routine x-rays.



1 week post-operative x-ray







No perforation was noted. Periodontally, probings were within normal limits.


3 year post-operative x-ray



Tooth is sound and patient is asymptomatic.










Comment:
MTA is the material of choice for internal resorption.  If you can probe into the resorbed area (in other words a perforation has occurred) MTA will not work.  Also note that many times it is extremely difficult to negotiate a canal system to the radiographic apex.  In this case the system that I was able to clean was entirely filled with MTA.  I would suggest a series of  routine 6 month post op exams when teeth are treated in this manner. If internal breakdown continues to occur, probably extraction is the only alternative.  Patients need to be aware on their first appointment.

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