Abstract
Since Ishikawa et al. introduced Vitapex® (Neo Dental Chemical Products Co., Ltd. Japan) in 1977, the material has been widely used in pulpectomized and infected root canal treatment. In this paper, we show that Vitapex® may have a high degree of absorbability from the obturated root canal. The patient was a 47-year-old female who had received infected root canal therapy by another dental practitioner. Three upper anterior teeth with large periapical cyst-like lesions (radiolucencies) had been followed by extrusive canal obturation with Vitapex® into the periapical rarefactions (lesions). The teeth were asymptomatic and there was no postoperative discomfort for 3 months after root canal filling. Radiographic examination revealed that the overfilled sealer (paste) showed a well demarcated or radiopaque mass just after the obturation, then gradually diffused and was absorbed, and that the paste radiopacity disappeared approximately 4 months later from part of the canal of a tooth. The diagnosis in the endodontic retreatment of the upper left central incisor was acute suppurative apical periodontitis with a large buccal swelling. Clinical and radiographic recalls after retreatment of the root canal by using the laminated root canal filling with FR-Ca paste had been done for 20 years. Endodontic retreatment of the involved tooth resulted in successful resolution and healing of periapical cystic lesions 20 years later. In this case, radiographs showed radiolucent lesions at apices of some lower incisors. The lesions were distinguished from infectious inflammatory lesions because the pulp appeared vital and the teeth were intact without any history of trauma. Periapical cemental dysplasia appeared to be a very likely possibility in this case. These teeth were followed for 20 years and no evidence of pulp involvement was clinically or radiographically evident.
