Surgical replacement of huge rate of root end amalgam filling with mineral trioxide aggregate angelus: A case report

Alireza Halaj-Mofrad, Masoud Parirokh, Nargessadat Kashi


BACKGROUND AND AIM: Surgical endodontics may sometimes fail despite using root-end filling materials (REFMs). In this case report, a symptomatic right maxillary first premolar underwent periradicular surgery (PS) for replacing huge rate of amalgam with mineral trioxide aggregate (MTA).

CASE REPORT: A thirty-year-old healthy woman attended with the chief complaint of recurrent swelling and abscess in the periradicular region of maxillary premolar tooth and sensitivity to percussion. She had a history of PS in the past year. Periapical radiographic images showed a huge rate of amalgam used as REFM. The PS was performed again and the amalgam was replaced with MTA. Postoperative clinical and radiographic evaluation after 2 years showed no sign of abscess and no sensitivity to percussion and periapical pathosis.

CONCLUSION: In this case report, replacing amalgam with MTA provided reasonable outcome up to 2 years after
the treatment.


Dental Amalgam; Failure; Mineral Trioxide Aggregate; Root Canal Filling Materials; Root-end Filling

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Kourkouta S, Bailey GC. Periradicular regenerative surgery in a maxillary central incisor: 7-year results including cone-beam computed tomography. J Endod 2014; 40(7): 1013-9.

Favieri A, Campos LC, Burity VH, Santa CM, Abad EC. Use of biomaterials in periradicular surgery: A case report. J Endod 2008; 34(4): 490-4.

Fernandez-Yanez SA, Leco-Berrocal MI, Martinez-Gonzalez JM. Metaanalysis of filler materials in periapical surgery. Med Oral Patol Oral Cir Bucal 2008; 13(3): E180-E185.

Asgary S, Eghbal MJ, Ehsani S. Periradicular regeneration after endodontic surgery with calcium-enriched mixture cement in dogs. J Endod 2010; 36(5): 837-41.

Frank AL, Glick DH, Patterson SS, Weine FS. Long-term evaluation of surgically placed amalgam fillings. J Endod 1992; 18(8): 391-8.

Baek SH, Plenk H, Jr., Kim S. Periapical tissue responses and cementum regeneration with amalgam, SuperEBA, and MTA as root-end filling materials. J Endod 2005; 31(6): 444-9.

Baek SH, Lee WC, Setzer FC, Kim S. Periapical bone regeneration after endodontic microsurgery with three different root-end filling materials: amalgam, SuperEBA, and mineral trioxide aggregate. J Endod 2010; 36(8): 1323-5.

Parirokh M, Torabinejad M. Mineral trioxide aggregate: A comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action. J Endod 2010; 36(3): 400-13.

Torabinejad M, Parirokh M. Mineral trioxide aggregate: A comprehensive literature review--part II: Leakage and biocompatibility investigations. J Endod 2010; 36(2): 190-202.

Parirokh M, Torabinejad M. Mineral trioxide aggregate: A comprehensive literature review--Part I: Chemical, physical, and antibacterial properties. J Endod 2010; 36(1): 16-27.

Bogen G, Kuttler S. Mineral trioxide aggregate obturation: A review and case series. J Endod 2009; 35(6): 777-90.

Bernabe PF, Holland R, Morandi R, de Souza V, Nery MJ, Otoboni Filho JA, et al. Comparative study of MTA and other materials in retrofilling of pulpless dogs' teeth. Braz Dent J 2005; 16(2): 149-55.

Torabinejad M, Hong CU, Lee SJ, Monsef M, Pitt Ford TR. Investigation of mineral trioxide aggregate for root-end filling in dogs. J Endod 1995; 21(12): 603-8.

Saatchi M, Shadmehr E, Talebi SM, Nazeri M. A prospective clinical study on blood mercury levels following endodontic root-end surgery with amalgam. Iran Endod J 2013; 8(3): 85-8.

Parirokh M, Zarifian A, Ghoddusi J. Choice of treatment plan based on root canal therapy versus extraction and implant placement: A mini review. Iran Endod J 2015; 10(3): 152-5.

Zhou W, Zheng Q, Tan X, Song D, Zhang L, Huang D. Comparison of mineral trioxide aggregate and iRoot BP plus root repair material as root-end filling materials in endodontic microsurgery: A prospective randomized controlled study. J Endod 2017; 43(1): 1-6.

Special Committee to Revise the Joint AAE/AAOMR Position Statement on use of CBCT in Endodontics. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120(4): 508-12.

Tortorici S, Difalco P, Caradonna L, Tete S. Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial. J Craniofac Surg 2014; 25(3): 804-7.


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