Retrograde with MTA Cement

A 48-year-old female presented with discomfort and slight numbness radiating to the right anterior lip. X-Ray #1 shows a 3-unit bridge with an old root canal and a long post in tooth #29. Also, there was an overfill of gutta percha and a space present between the post end and the gutta percha.

In addition, there was a periapical radiolucent area very close to the mental nerve. Clinically, periodontal probing was within normal limits. There was discomfort to percussion and palpation. Diagnosis: Periapical abscess as a result of a failing root canal. Treatment consisted of an apicoectomy with MTA cement retrograde filling.

(*Please see MTA information in the advances in technologies section)

Notes: The mental foramen is very close to the apex of tooth #29. The numbness was a result of the apical (abscess) pressure on the mental nerve.

X-Ray #1: Pre-op of tooth #29 
Retrograde with MTA Cement

 X-Ray #2: Post-op of tooth #29. Apicoectomy with MTA cement retrograde filling
Retrograde with MTA Cement
 Microscopic picture of MTA retrograde filling
Retrograde with MTA Cement

*Notes: 2 weeks after surgery, the numbness and all discomfort subsided. To ensure that the mental nerve is not traumatized, the bevel of the root end must be initiated coronal to the apex.