Successful Surgical Management of Periapical Cyst with Accidentally Extruded MTA through Open Apex - A Case Report with One Year Follow up

Abstract

ABSTRACT An immature tooth with a blunderbuss canal presents a challenge in achieving a hermetic seal. Closure of the wide-open apex with materials such as mineral trioxide aggregate (MTA), biodentine, and endosequence root repair material is required to achieve success. Despite following proper methods, the extrusion of filling material into the periapical region is unavoidable. In this case report, due to a lack of apical stop, MTA was extruded unintentionally. Endodontic surgery was performed to remove the extruded MTA and curettage of the apical lesion was done to remove the cystic lining. Follow-up after regular intervals of 1, 3, 6 months, and 1 year showed resolution of periapical radiolucency with radiopaque corticated borders surrounding the radiolucency. This case report describes the successful surgical management of accidentally extruded MTA through large wide-open apex. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY Surgical planning involved flap design in collaboration with periodontist for preservation of the interdental papilla.