Bedah Apikal Dengan MTA dan Bone Graft pada Gigi dengan Kista Radikuler: Laporan Kasus

Background: Apical surgery is an important treatment alternative in the presence of a large periapical cyst. To achieveoptimal healing and regeneration of the bone different bone substitutes can be used. Purpose: This case report aims to description that an apical surgery was indicated to failure in conventional endodontic treatment. Case: A 18 years old female in the left maxillary lateral incisors #22 post endodomtic treatment 3 years ago and felt uncomfortable (dull pain). Clinically, the tooth was hypersensitive to percussion and palpation. Periapical radiograph was taken using the standardized techniques, which revealed a large radiolucent lesion around the apex (ø 10 mm) and over filled gutta percha and resin sealer. Case Management: Retreatment of root canal with resiproc R40 and obturation of the root canal retrogradly was followed by apex resection ultrasonic retropreparation, and then retrograde root filling with MTA and bone graft is used to accelerate the formation of the jawbone after scraped cyst. At the 6 month follow-up visit, the tooth showed progressive healing. Conclusion: Treatment on tooth 22 with pulp necrosis with periapical lession can be performed with endodontic surgery. Retrograde root filling with MTA is the right alternative and the use of bone graft increases bone formation