Non surgical endodontic retreatment of immature permanent anterior teeth with iatrogenic overextended filling: A case report.

  • Ather Ahmed Syed
  • Alok Dubey College of Dentistry, Jazan University, Jazan, Saudi Arabia
  • Sheetal Mujoo Assistant Professor, Department of Oral Medicine & Radiology
  • Alok Avinash Rungta College of Dental Sciences, Bhilai


The completion of root development and closure of the apex occurs up to 3 years after eruption of the permanent tooth. The treatment of pulpal injury during this period provides a significant challenge for the clinician. Conventional endodontic treatment in a non vital tooth will result in overfilling of the obturating material as there is no apical stop for the obturating material. Hence knowledge of the biological process of root development is must to avoid endodontic failure. Here we present a case report where nonsurgical endodontic retreatment was successfully done to remove the overextended gutta-percha from immature permanent teeth. Apexification was carried out by placing an apical plug of MTA. This paper even throws light on causes of endodontic failures, option available to retrieve the old filling material and the significance of preoperative radiograph in establishing the root condition before carrying out any endodontic procedure.

Author Biographies

Alok Dubey, College of Dentistry, Jazan University, Jazan, Saudi Arabia

Associate professor, Department of Pediatric Dentistry

Sheetal Mujoo, Assistant Professor, Department of Oral Medicine & Radiology

College of Dentistry, Jazan University, Jazan, Saudi Arabia

Alok Avinash, Rungta College of Dental Sciences, Bhilai

Reader, Department of Pediatric Dentistry


1. Valois CR, Navarro M, Ramos AA, Castro AJ, Gahvya SM. Effectiveness of the ProFile.04 Taper Series 29 files in removal of gutta-percha root fillings during curved root canal retreatment. Braz Dent J. 2001; 12(2): 95-99.
2. Abou-rass M. Evaluation and clinical management of previous endodontic therapy. J Prosthet Dent. 1982; 47(5): 528-534.
3. Ruddle CJ. Nonsurgical endodontic retreatment. J Endod. 2004 Dec; 30(12):827-45.
4. Bhat SV, Suvarna N, Shetty KHN, Varma KR. Comparison of efficiency of gutta percha removal in retreatment using protaper retreatment files, RaCe instruments with and without H files- an ex vivo evaluation. Endodontology. 2010; 22(2): 33-43.
5. Khabbaz MG, Papadopoulos PD. Deposition of calcified tissue around an overextended gutta-percha cone: case report. Int Endod J. 1999; 32(3): 232-235.
6. American academy of pediatric dentistry. Guideline on pulp therapy for primary and immature permanent teeth. Reference manual 2011-12; 33(6): 212-219.
7. Rafter M. Apexification: a review. Dent Traumatol. 2005; 21(1): 1–8.
8. Ezzie E, Fleury A, Solomon E, Spears R, He J. Efficacy of retreatment techniques for a resin-based root canal obturation material. J Endod. 2006; 32(4): 341-344.
9. Schirrmeister JF, Meyer KM, Hermanns P, Altenburger MJ, Wrbas KT. Effectiveness of hand and rotary instrumentation for removing a new synthetic polymer-based root canal obturation material (Epiphany) during retreatment. Int Endod J. 2006; 39(2): 150-156.
10. Cunha RS, De Martin AS, Barros PP, da Silva FM, Jacinto Rde C, Bueno CE. In vitro evaluation of the cleansing working time and analysis of the amount of gutta-percha or Resilon remnants in the root canal walls after instrumentation for endodontic retreatment. J endod. 2007; 33(12): 1426-1428.
11. Mollo A, Botti G, Goldini P, Randellini E, Paragliola R, Chazine M, Ounsi HF, Grandini S. Efficacy of two Ni-Ti systems and hand files for removing gutta-percha from root canals. International Endodontic Journal. 2012; 45(1):1-6.
12. Ruddle CJ. Nonsurgical endodontic retreatment. J Calif Dent Assoc. 2004; 32(6):474-84.
13. Friedman S, Stabholz A, Tamse A. Endodontic retreatment--case selection and technique. 3 Retreatment techniques. J endod. 1990; 16(11): 543-9.
14. Bergenholtz G, Lekholm U, Milthon R, Engstorm B. Influence of apical overinstrumentation and overfilling on re-treated root canals. J Endod. 1979; 5(10): 310-314.
15. Kfir A, Tsesis, Yakirevich E, Matalon S, Abramovitz I. The efficacy of five techniques for removing root filling material: microscopic versus radiographic evaluation. International Endodontic Journal. 2012; 45(1): 35-41.
16. Barletta FB, Rahde Nde M, Limongi O, Moura AA, Zanesco C, Mazocatto G. In vitro comparative analysis of 2 mechanical techniques for removing gutta-percha during retreatment. J Can Dent Assoc. 2007; 73(1): 65.
17. Aguiar CM, Lima GAC, Bernart FD, Camara AC. Effectiveness of the Pro Taper Universal Retreatment system and manual technique in endodontic retreatment. Acta Stomatol Croat. 2011; 45(4): 239-246.
18. Dall Agnol C, Hartann MS, Barletta FB. Computed tomography assessment of the efficiency of different techniques for removal of root canal filling material. Braz Dent J. 2008; 19(4): 306-312.
19. Unal GC, Kaya Bu, Tac AG, Kececi AD. A comparison of the efficacy of conventional and new retreatment instruments to remove gutta-percha in curved root canals: an ex vivo study. International endodontic Journal. 2009; 42(4): 344-350.
20. Bueno CE, Delboni MG, de Araujo RA, Carrara HJ, Cunha RS. Effectiveness of rotary and hand files in gutta-percha and sealer removal using chloroform or chlorhexidine gel. Braz Dent J. 2006; 17(2): 139-143.
21. Hammad M, Qualttrough A, Silikas N. Three-dimensional evaluation of effectiveness of hand and rotary instrumentation for retreatment of canals filled with different materials. J Endod. 2008; 34(11): 1370-1373.
How to Cite
SYED, Ather Ahmed et al. Non surgical endodontic retreatment of immature permanent anterior teeth with iatrogenic overextended filling: A case report.. Journal of Oral Health Research, [S.l.], v. 8, n. 1, p. 12-18, aug. 2017. ISSN 2229-6018. Available at: <>. Date accessed: 17 nov. 2019.
Case Report