engleski

Orthograde revision of failed endodontic therapy supported by retrograde surgery and photodynamic laser disinfection and retrograde sealing with bioactive material

Failure of endodontic therapy indicates revision of endodontic treatment, and this is not necessarily an orthograde conventional therapeutic approach. Retrograde surgical approach to the apex third of the canal and application of photodynamic therapy, enables direct chemomechanical action in the area of accessory canals, isthmuses and deltas, which are abundant with bacterial biofilms. This creates the prerequisites for the final retrograde sealing with bioactive material which promotes healing and regeneration with supporting tissue. The patient arrives to the Department of Dental Diseases of the Dental Clinic of KBC Zagreb due to dissatisfaction with the aesthetics of the teeth in the upper front. The teeth are without clinical symptoms and subjective complaints. The pateint cites childhood trauma. Clinical examination demonstrates a mild periapical sensitivity on palpation of the tooth 11 and none of the tooth 21. There is no sensitivity to percussion nor any tooth mobility. A revision of the endodontic treatment on both teeth is carried out. The canals are filled with the Thermafil system and MTA-Fillapex paste. After X-ray control of the performed endodontic treatment, surgical flap is lifted and granulations are excised. The retrograde 3-4mm deep cavity is prepared and photodynamic disinfection with the HELBO laser and methylene blue HELBO Blue is done. The cavity is closed with MMMTA bioactive material. After four months, a control examination is carried out. The clinical findings are normal, and the X-ray image shows the healing of the lesions and restitution of the newly formed bone. Post-endodontic restoration is completed with the full ceramic crowns. Biofilms that remain in insufficiently chemomechanically treated canals are the cause of failure of endodontic therapy and often require the use of modern procedures such as photodynamic therapy and treatment with bioactive materials.

trauma ; revision ; photodynamic laser disinfection ; retrograde filling ; bioactive material ; regeneration

nije evidentirano