Periradicular surgery with retrofilling by MTA Repair HP® having concomitant cone beam computed tomography follow-up analysis: case series report

Abstract

Aim: To evaluate, tomographically, in two clinical cases, the effect of the new MTA formulation of the Angelus, the MTA Repair HP, in the contribution to remission of periapical lesions in paraendodontic surgery, as well its physical properties and manipulation. Case report: Patient R.C.R, 57, attended at the Faculty of Dentistry of the Federal University of Juiz de Fora for evaluation of periapical lesion in the element 11. It was observed, at the clinical and radiographic exams, endodontic treatment and a circumscribed, unilocular and radiolucid area at the apex of the tooth. It was requested a CBCT exam (I-Cat®, Imaging Sciences International, Hatfield, Pennsylvania, USA), which confirmed the presence of the lesion and rupture of the buccal cortical plate. Thus, it was performed curettage, apicectomy, retropreparation and retrofilling with the described cement. It was solicited two additional CBCT exams at the period of three and five months post-operative. Patient R.J.G.M, 46, with mean complain of pain, increased intraoral volume and purulent discharged in the upper left arch. The clinical and radiographic exams revealed fistula and refractory lesion, despite the endodontic treatment of the tooth 25. A CBCT exam was done and it was observed a circumscribed hypodense area, around the apex of the 25, with rupture of the buccal cortical plate. It was suggested the same surgical treatment described in the case above. It was performed two more CBCT exam, at three and five months after the procedure. Discussion: The MTA Repair HP was developed from the necessity of a more biocompatible material with the dental structures in the retrograde filling process. This product helps in the remission of periapicals lesions and in the new formation of the periodontum components; also it has the advantages of longer setting time, not causing the darkening of the coronary portion and easier manipulation. Conclusion: Regarding the remission of the lesions, it was noticed the generation of calcified tissue across the periods of three and five months. Regarding the manipulation and application, it was not observed any improvement related to the addition of the plasticizer. However, it was noticed a shorter setting time, making it difficult to insert the material.

Keywords

• cirurgia bucal
• obturação retrógrada
• tomografia computadorizada de feixe cônico
• regeneração óssea