Periapical surgery of a tooth with crack in the root apical third and metallic core retainers: case report
DOI:
https://doi.org/10.47456/rbps.v22i3.27239Keywords:
Oral surgery, beam computed tomography, EndodonticsAbstract
Introduction: Vertical root fractures affect both vital pulp teeth and treated or non-endodontically devitalized teeth. The highest prevalence is related to teeth with endodontic treatment. Paraendodontic surgery presents itself as an alternative for the resolution of problems arising from conventional or non-solvable endodontic treatments. Objective: The objective of the present study was to present the surgical treatment of a tooth treated endodontically with vertical crack restricted to the apical third of the root and chronic periapical lesion. Methods: The methodology consists of an individual descriptive study of the case report type, including clinical, radiographic and tomographic images of a female patient, 55 years old, being referred to the discipline of Endodontics II for the planning of paraendodontic surgery. Cone-beam computed tomography, with paraassagital and axial sections, were requested from the gutta-percha/intraradicular metal retainer interface in the apical direction, in which a hypodense line was observed in the third apical radicular suggestive of cracking. On the day of surgery, the treatment was performed following the general principles of paraendodontic surgery: incision, divulsion, ostectomy, curettage, removal of the apical third (apicetomy), retroprepare including removal of gutta-percha and retrofilling with Mineral Trioxide Aggregate. Results: After the period of proservation, performed at six and twelve months, we observed clinical and imaging signs compatible with the tissue repair of the injured area. Conclusion: Thus, it can be concluded that paraendodontic surgery is a viable alternative for teeth with vertical cracks restricted to the root apical third associated with persistent periapical lesions after conventional endodontic treatment.
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