Chronic Apical Periodontitis with Calculus-like Mineral Deposit on the Root Apex: A Case Report

We report a case of a large calculus-like mineral deposit on the root apex as persistent apical periodontitis. The patient was a 54 years old male who presented with persistent gingival fistula at the maxillary right lateral incisor. An apicoectomy was performed because of post-endodontic gingival fistula and the calculus was excised completely. Then the fistula was closed. The resected calculus-like deposit, the supra-gingival and sub-gingival calculi from the same patient were examined byscanning electron microscopy under which the surface morphologies are different: fibrous calcified mass; flaky calcified mass and spherical calcified mass and infrared spectroscopy which showed the characteristic functional groups of the three specimens been exactly same but the waveforms varied. The tooth presents with a palatal additional root on radiograph. Free mineral ions and mineral salts may have accumulated via the fistula at the root apex and led to mineralization of the dental plaque and inflammatory tissues and formation of the special minerals.