Journal of Dental Sciences
Volume 5, Issue 2 , Pages 109-113, June 2010

Refractory apical periodontitis associated with a calculus-like deposit at the root apex

  • Cheng-Mei Yang

      Affiliations

    • Department of Dentistry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
    • ,
  • Yao-Dung Hsieh

      Affiliations

    • Department of Dentistry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
    • Graduate School of Dental Science, National Defense Medical Center, Taipei, Taiwan
    • ,
  • Shue-Fen Yang

      Affiliations

    • Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
    • School of Dentistry, National Yang-Ming University, Taipei, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Stomatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei 11221, Taiwan

Received 11 February 2010; accepted 20 April 2010.

Article Outline

In this case report, we describe a refractory case in which a calculus-like deposit was found at the apical root surfaces of two adjacent teeth. This case involved a 45-year-old male with a sinus tract at the labial mucosa of the maxillary left central incisor, which did not heal after conventional root canal treatment of the maxillary left lateral incisor. Periradicular radiolucencies and unusual radio-opacities were noted on the root surfaces of the vital maxillary left central incisor and prior endodontically treated lateral incisor. Subsequent surgery found calculus-like particles at the root surface of both teeth. A pathology examination revealed calculus-like particles scattered in the granulomatous tissue. A test cavity confirmed pulp necrosis of the maxillary central incisor, and endodontic treatment was performed 1 year after surgery. At the 20-month recall, the size of the periapical radiolucency had decreased. The presence of calculus-like particles at the root surfaces was noted and may have possibly contributed towards the etiology of root canal treatment failure.

Key Words:  apical periodontitis , biofilm , calculus , extraradicular infection

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PII: S1991-7902(10)60015-3

doi:10.1016/S1991-7902(10)60015-3

Journal of Dental Sciences
Volume 5, Issue 2 , Pages 109-113, June 2010

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