Treatment of wide-open blunderbuss apex in adult

―Case report of apical periodontitis via resin restration of central tubercle―

Abstract

Abstract : In the endodontic therapy of the pulpless permanent tooth with a wide-open blunderbuss apex, apexification is useful treatment for apical closure. In this case report, treatment of apical periodontitis via resin restration of central tubercle of lower left second premolar was done to adult. The tooth has been prepared on the occlusal surface and restored with resin filling about 10 years ago. Since then, patient has been always suffered from discomfort and fistula on the patient tooth. On the x-ray film, large periapical lesion was observed. After removal of composite resin, no caries was observed in the cavity, but a small hole was observed on the cavity floor. The pulp was none vital so root canal treatment was done and filled with calcium hydroxide successively. When apexification was completed and periapical lesion disappeared after five months, root canal filling with vertical condensation of gutta perch was done. After one year from root canal filling, patient has no problem on the lower left second premolar.