PT  - JOURNAL ARTICLE
AU  - Pragya Pandey
AU  - Tanya Nandkeoliar
AU  - Rhythm Bains
AU  - Diksha Singh
TI  - Use of mineral trioxide aggregate for retreatment of a tooth with large periapical lesion, wide-open apices and vertical root fracture
AID  - 10.1136/bcr-2018-227627
DP  - 2018 Nov 05
TA  - BMJ Case Reports
PG  - bcr-2018-227627
VI  - 2018
4099  - http://casereports.bmj.com/content/2018/bcr-2018-227627.short
4100  - http://casereports.bmj.com/content/2018/bcr-2018-227627.full
AB  - Chronic periapical lesions in necrotic teeth with open apex are difficult to manage. The situation becomes more complex if the tooth has a fracture line. This case report describes the management of a traumatised tooth that had already undergone unsuccessful endodontic treatment with a large periapical lesion and open apex along with a fracture line in the root. An attempt was made to save the tooth by using mineral trioxide aggregate (MTA) cement for orthograde filling, retrograde filling and also for sealing of the fracture line. Moreover, the bone defect was filled with autogenous bone harvested from the external oblique ridge. MTA, a bioactive tricalcium silicate cement, has been used in treating complex endodontic cases as it shows promising potential by inducing the biological mechanisms necessary for repair of involved teeth. A 1-year follow-up showed progressive healing as evident by radiographs and lack of any clinical signs and symptoms.