Surgical Retreatment of an Invaginated Maxillary Central Incisor Following Overfilled Endodontic Treatment: A Case Report

This case report presents the periapical surgical retreatment of an Oehlers Class III invaginated maxillary central incisor with extruded root canal filling into the periapical lesion. After local anesthesia, a full-thickness mucoperiosteal flap was reflected, and the granulomatous tissue and extruded gutta-percha points were curetted carefully. A deep and wide root-end cavity was prepared and filled with mineral trioxide aggregate (MTA). At 6 months and 2 years after the treatment, the tooth exhibited no clinical symptoms, and the radiograph performed during the 2-year follow-up showed a complete periapical healing around the root end. The present report indicates that MTA retrofilling can be used successfully in the surgical retreatment of dens invaginatus type III cases in which the invagination exits apically.