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Lucas do Nascimento TAVARES (a) Karla ZANCOPÉ (a) Anielle Christine Almeida SILVA (b) Luís Henrique Araújo RAPOSO (a) Carlos José SOARES (c) Flávio Domingues das NEVES (a)

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The aim of this clinical report is to present the replacement of unsatisfactory metal-ceramic crowns of elements 12, 11, 21 and 22, by lithium disilicate glass-reinforced ceramic crowns in a patient with skeletal anterior open bite. A patient sought care at the Dental Hospital at the School of Dentistry of UFU, complaining of odor between the metal-ceramic crowns of the antero-superior teeth. After clinical and radiographic examination, invasion of the biological space was noticed, surgery was indicated in order to restore the biological space. After healing, the pre-existing cast metal posts were masked using an opaque composite resin and the teeth were reprepared for full all-ceramic crowns. Impressions were taken in two steps, using PVS associated to retraction cords. The ceramic copings were obtained in lithium disilicate ceramic, and the veneering was performed by stratification. After testing the ceramics crowns in relation to, fit, function and aesthetic results, cementation was completed using modified absolute isolation, followed by prophylaxis of preparations with pumice and saline, surface treatment of the ceramic restorations and luting using self-adhesive resin cement. Finally, an occlusal splint was produced to control the effects of bruxism and orofacial pain symptoms. The anterior open skeletal bite was a challenging factor for the rehabilitation of this patient; however, one must consider the entire process that the patient would undergo if choosing for orthognathic surgery, and the patient should be aware of the case limitations. In addition, the use of lithium disilicate glass-reinforced ceramics proved the versatility of this material for anterior aesthetic restorations.

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Cite this article: Rodrigues Nascimento Oliveira Tavares N, Veloso Carvalho de Oliveira MA, do Nascimento Tavares L, da Mata Galvão A, Melo Caram C, Rodrigues da Silva G. Endodontic retreatment using MTA-based sealants in a tooth with perforation and periapical lesion. Stoma Edu J. 2017;4(4):298-301Introduction: To report an endodontic retreatment with a root perforation and use of reparative cement and filling sealant based on mineral trioxide aggregate (MTA). Summary: Retreatment in teeth with root perforations can reduce the longevity of the treatment, because it depends on the rapid location and proper sealing, with biocompatible materials that promote tissue repair. A female patient came to the dental office complaining of pain in tooth 36, with an indication of retreatment on it. Radiographically, it presented thickening of the periodontal ligament and periapical lesion in the mesial and distal roots, leading to the diagnosis of chronic apical periodontitis. With the help of an operative microscope, it was possible to find a perforation in the most cervical portion in the furcation region of the mesio-vestibular root canal. To treat this perforation, it was filled with MTA HP Repair, to enable preparation of root canals and subsequent filling with MTA Fillapex, through the Schilder Plus technique and execution of a 12mm relief on distal root for placement of the intra-radicular retainer. Rehabilitation of teeth with root perforations can be performed with MTA-based filling sealants, presenting satisfactory results for repairs in cases of perforations and periapical lesions. Key learning points: -Root perforations are accidental unwanted complications that can occur in stages of the endodontic treatment; -The prognosis for endodontic perforations depends on the size and location of the defect and how quickly the perforated area was sealed with biocompatible material.

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