The use of re-surgery in the treatment of teeth with severe sensitivity in the buccal mucous ‎membrane: A case report with 75 months follow-up

BACKGROUND AND AIM: A periapical endodontic surgery is an alternative treatment when teeth are not responding to conventional treatment and endodontic re-treatment.CASE REPORT: The following case report presents a clinical case of maxillary right and left central incisors with unsatisfying endodontic surgery and severe sensitivity in the buccal mucous membrane. Radiographic examination revealed several fragments of amalgam as root-end filling material, surrounded by a periapical radiolucent area. The chosen treatment plan was to perform endodontic retreatment. Symptoms persisted in spite of the gutta-percha removal and calcium hydroxide intracanal medication. Hence, periradicular re-surgery was performed. However, deep tissue penetrated amalgam particles were difficult to explore and could not be removed completely. The root-end filling was done with mineral trioxide aggregate (MTA), and the lesion was subjected to histologic analyses. The treatment was successful due to the absence of painful symptoms and due to periapical bone repair after 75 months follow-up.CONCLUSION: MTA can be used successfully in the situations with failed previous periradicular surgery with amalgam.