Abstract
We experienced a rare case in which the over root canal filling with Vitapex in the deciduous tooth was the cause of a transposition and a dentinogerous cyst formation on the maxillary left permanent central incisor germ.
On filling the maxillary left deciduous central incisor of a three-year and nine-month-old female with Vitapex, heavy material 3×11 mm in size was extruded from the apex into the center of the permanent tooth germ. Six months later, there were no subjective symptoms, but unusual bony swelling occurred at the labial plate of the maxillary left deciduous central incisor. On the roentgenograms the extruded material was no longer seen but radiolucency resembling a dentinogerous cyst appeared around the crown. We treated the case by extracting the deciduous tooth and by marsupialization at the lesion of the permanent tooth. Consequently the lost filling material remained at the lingual side of the permanent tooth germ and was forced down against the labial side. Furthermore two years later, the permanent tooth germ moved a little to the lingual side, the radiolucency surround the permanent tooth germ disappeared, and the root formation started.
The results were as follows,
1. With deciduous teeth filling with Vitapex, excessive root canal filling must be avoided.
2. At the stage of crown completion, transposition and dentinogerous cyst formation may lead to root delaceration, the transposition of teeth or the discontinuity of permanent tooth development. It was best that we undertook marsupialization treatment actively in order to avoid these impedimentia.
