Orthograde Apical Application of an MTA Plug in a Tooth without Constriction - A Case Report

The periapical area in teeth with chronic lesions is characterized by changes in the adjacent bone structure and periodontal ligaments, as well as in the cement and dentine. In a large percentage of cases, the apical physiological constriction is ether absent or expanded. The absence of a constriction makes it a challenge to achieve satisfactory treatment results.The present case report describes the re-treatment of a case of a mandibular molar, complicated by lack of constriction and a separated endodontic instrument. Mineral trioxide aggregate (MTA) was used for a 5-mm apical plug to avoid overfilling of the sealer when the root canal was definitely obturated. The periapical radiographs showed satisfactory images of periapical bone density and the tooth was asymptomatic on precision. MTA is proved to be an appropriate material for apical sealing in cases with resorption, as it leads to avoidance of apical surgical procedures with a similar prognostic outcome.