An unusual foreign body associated with an endodontically treated tooth: report of a case

Abstract

The use of amalgam as a restorative material in dentistry is axiomatic. Its use in endodontics as a retrofilling material is well documented. Studies dealing with the biocompatibility of amalgam indicate that it is well tolerated in soft tissue 14 and cell cultures, s Some authors 6 have suggested that amalgam may even be less irritating than gutta-percha. Silver amalgam is presently the preferred material in endodontic surgery that requires a retrograde filling. The use of zinc-containing alloy has been challenged by.Omnell 7 because it was believed to have resulted in the formation of a zinc-carbonate precipitate in association with a root canal containing a post. The zinc-carbonate combination was believed to have been responsible for the eventual failure of the case reported in the literature. However, other authors 811 have shown little if no difference between zinccontaining and zinc-free amalgam. Although not as popular today as in the past, two root canal sealers (Kerr and AH-26) contain precipitated silver for increased radiopacity. In 1960, Orban and Wentz 12 reported localized argyria after obturation using root canal cement that contained silver. Localized argyria has also been repoted by KirchoW 3 after surgical endodontic treatment in teeth containing silver cones. On occasion, we have seen soft tissue argyria in teeth that have undergone root resection, which were obturated with guttapercha using a silver-containing sealer. The following case report describes an intraosseous discoloration strongly suggestive of argyria. It was associated with chronic periapical inflammation in an endodontically treated tooth. The root canal sealer was suspected of being the causative factor.