Clinical management in the face of extensive periapical lesion with the presence of a fused metal core

Abstract

This study aims to present a clinical case of retreatment of a tooth with an extensive periapical lesion with the presence of a fused metal core and clinical and radiographic preservation after two years. A 56-year-old female patient was referred for dental treatment due to the need for retreatment in elements 21 and 22. On clinical examination, the presence of fistula was observed and the patient reported pain on vertical and horizontal percussion, absence of periodontal pocket, and on radiographic examination extensive periapical bone radiotransparency, presence of filling material, as well as molten metal nuclei were observed. Retreatment was performed with rotary instrumentation (Prodesign Logic RT ®). 2.5% Sodium Hypochlorite was used as an irrigating solution, and the intracanal medication used was calcium hydroxide paste (UltraCal®). The filling of the root canal system was performed by the single cone technique associated with active lateral condensation and AH-Plus cement. It is concluded that endodontic retreatment associated with intracanal medication renewal determined clinical and radiographic success.