Tertiary dentin deposition in the proximity of the cervical perforation aperture – A case study

Abstract

Dead tracts are dentin areas characterized by degenerated odontoblastic processes; may result from injury caused by caries, attrition, erosion, or cavity preparation. Odontoblasts can also form tertiary dentin, as a response to injury, in association with caries, trauma, or restorative procedures. Generally, this dentin is less organized than primary and secondary dentin and mostly localized to the site of injury. The reactive dentin formation that lays under caries, the pulp displays chronic inflammation and tertiary dentinogenesis takes place on the inner walls of the pulp space, in the region of the dentinal tubules associated with the base of the carious lesion. Higher-power photomicrograph of tertiary dentin shown in a primary dentin, first period of tertiary dentin formation, second period of tertiary dentin formation. We initiated a case study regarding depositition of tertiary dentin in the close proximity of the cervical perforation hole on mesial root of the second maxillary molar. The repair material used (Biodentine, Septodont) was found placed under the tertiary dentin layer, rather than at the perforation place, mentioning the fact that the group of residents was not experienced with the management of the endodontic microscope and did not use a proper field. We consider that we have identified dead tracts due to the fact that they were formed consequently carious lesions pathology, thereafter the tertiary dentin at the appearance of the coronal aspect was identified at the end of the dead tracts. The portion of the canal entrances were investigated both with analyzed filters (Crossed Polars) and with compensatory devices (retardation plates). The present study identified tertiary dentine deposits in the coronary portion of the adjacent root canal entered in the perforation. At a thorough analysis of the coronal portions of the mesial root canal with compensating devices and analyzers filters, it was noticed a soft dentin blanket in which the dentinary tubules do not exist or are of very rare deposition.