Efficiency of Bioceramic Cement and Photodynamic Therapy Used During Apicoectomy for Perforated Root Canal

Abstract

Background: This study was conducted to assess the efficiency of bioceramic cement and photodynamic therapy used during apicoectomy for perforated root canal.

Material and methods: This study comprised of 10 patients who reported for root canal treatment. It was found that out of 10 patients, 5 had perforated root canal. So, apicoectomy was decided to be the choice of procedure for treatment using bioceramic cement and photodynamic therapy. The procedure was explained to the subjects and the subjects were asked for consent. the subjects who gave consent had been included in the study. The mean age of the subjects was 26.8 years. The root canal was first disinfected followed by instrumentation with RECIPROC system R40/0.06 file and irrigated by sodium hypochlorite 2.5% and ethylenediaminetetraacetic acid with detergent (EDTA-T). The canal was thereafter rinsed with 10 mL of sterile saline solution to eliminate any chemical residue and dried using paper points #40. The aPDT procedure involved introducing methylene blue 0.005% into the canal and leaving it there for 5 minutes as a preirradiation period. The irradiation process was conducted via a low-power diode laser and an optical fiber inserted into the canal. The irradiation was conducted utilizing a visible red wavelength of 660 nm and an output power of 100 mW/cm2 for a continuous duration of 2 minutes. The irradiation followed a helical movement from the apical to cervical direction. A energy density of around 120.0 J/cm2 was utilized.The root canal was filled with gutta-percha and Ah Plus sealant at the same session. There was no administration of medicine prior to or throughout the course of treatment. The patient was instructed to administer acetaminophen (500 mg) up to four times daily as needed for pain relief. Following tomographic planning, the apicoectomy procedure was carried out with local anesthesia using a single anesthetic tube containing 4% articaine with epinephrine at a ratio of 1:100,000. Intraoral access to the lesion was established by making an incision in the buccal region from teeth 11 to 24. Following the removal of the flap, the perforation was evident, and a little osteotomy was carried out to create a surgical opening using a surgical carbide drill no. 06 with thorough irrigation using sterile saline solution.

Results: All the cases of perforated root canal were successfully treated with bioceramic cement and photodynamic therapy. Bioceramic cement played its role to the fullest in sealing the exposed periapical area of teeth, induction of repair of periapical lesion and in providing good marginal adaptation while photodynamic therapy played role in disinfecting the canal effectively.

Conclusion: Biceramic cement and photodynamic therapy are effective when used during apicoectomy for treating a perforated root canal.