Successful management of a tooth with canal obstruction using “cold ceramic”

Abstract

One of the causes of treatment failure is calcification in the canal pathway, which prevents complete
access to proper working length, and one of the most difficult and challenging cases of root canal
treatment has been reported. In some cases, the dentist will not be able to open the calcified canal.
Therefore, the prognosis of root canal treatment in these cases has been reported poor, and the dentist
will offer a plan for possible treatments, including tooth extraction or apical surgery. The presented case
is one example of those cases with a periapical lesion, which as a temporary treatment, the pulp chamber
was filled with cold ceramic. This material, which is an MTA‑like (Mineral Trioxide Aggregate) bioceramic
with proper sealing ability, has been introduced as a root‑end filling material. After 6 years of which
the patient returned, he did not express any pain or discomfort during these 6 years. Furthermore, in
radiograph that was taken, periapical lesion relative healing and bone regeneration were amazingly seen.
Key Words: Ceramics, root canal filling materials, root canal therapy, tooth calcification