Extruded guttapercha retrieval using a barbed broach and MTA apical barrier in a tooth with open apex – A case report

Pai, Dr.A.R.Vivekananda and Varghese, Chacko and *, Megha Pradhan (2014) Extruded guttapercha retrieval using a barbed broach and MTA apical barrier in a tooth with open apex – A case report. International Journal of Dental Case Reports, 4 (1). pp. 45-51.

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Abstract

Introduction: Ext ruded guttapercha (GP) may have the potential to act as a foreign body and initiate or sustain a periapical lesion thus affecting the healing. Therefore its retrieval may be deemed necessary requiring either periradicular surgery or retract ion through the apical foramen. Barbed Broaches have been suggested for use for retrieval of GP fragments from canals. However, cases of extruded GP retrieval using barbed broaches are rarely or seldom reported. Artificial apical barrier format ion using mineral trioxide aggregate (MTA) is now suggest ed as an alternative to traditional calcium hydroxide apexification procedure for apical closure in an immature tooth with open apex as it overcomes the disadvantages of calcium hydroxide apexificat ion. Case Report : A 10 year old boy who was undergoing endodontic retreatment in a young permanent tooth was found to have some fragments of GP ext ruded into the peri-apical area. These GP fragments were retrieved non-surgically by the use of a fine sized barbed broach. The endodontic treatment was later completed by using MTA to form an artificial barrier followed by obturation using GP. Discussion: In young patients retrieval of ext ruded GP is usually done by non-surgical means. In this case, attempted retrieval with an H file proved to be unsuccessful probably due to the softened nature of the GP. However the extruded GP fragments were successfully removed using a fine sized barbed broach. The endodontic treatment was later completed using MTA to form an art ificial barrier followed by obturation with GP. Conclusion: Barbed broaches, due to the presence of sharp barbs, are effect ive for engaging and ret rieving extruded GP through an open apex by mechanical means.MTA apical barrier procedure is useful to complete endodontic treatment and post endodontic restoration in an immature tooth with open apex of a non-compliant patient.

Item Type: Article
Uncontrolled Keywords: Apical barrier; barbed broach; endodontic retreatment; guttapercha retrieval; MTA; open apex
Subjects: Dentistry > MCODS Mangalore > Conservative Dentistry
Dentistry > MCODS Mangalore > Pedodontics
Depositing User: KMCMLR User
Date Deposited: 12 Apr 2014 07:44
Last Modified: 12 Apr 2014 07:44
URI: http://eprints.manipal.edu/id/eprint/139351

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