Mandibular molars display a wide spectrum of intricate anatomical variations among the Indian population. This case report details the diagnosis and successful endodontic management of a mid-mesial canal in the mandibular first molar tooth, emphasizing the importance of radiographic imaging and meticulous instrumentation. The patient presented with symptoms of irreversible pulpitis that led to accurate relief of symptoms after shaping and cleaning protocols were followed. This case series discusses the challenges encountered during canal negotiation, cleaning, shaping, and obturation, providing insights into the complexities associated with mid-mesial canals.

Pulpal and periapical pathosis in an immature anterior tooth following traumatic injury is a frequent occurrence, and management of open apices in such cases poses a constant challenge to endodontists. This is due to the absence of apical constriction that would result in poor three-dimensional seal/adaptation of the obturated material within the canal system. Treatment of immature pulpless teeth with long-term calcium hydroxide may consequently weaken the dentin and increase the fracture susceptibility. Obturating the root canals completely with bioactive agents like Biodentine/mineral trioxide aggregate (MTA) has benefits like increased fracture resistance when compared to apexification. When used for obturation, Biodentine™, a new calcium silicate-based cement, performs superior to other Portland cement derivatives. This case report demonstrates a six-month follow-up result of an open apex and a periapical lesion involving maxillary right central incisor #11 with the Biodentine obturation that was previously subjected to triple antibiotic paste as an intra-canal medicament for three weeks. The satisfactory healing rate of tooth 11 with the reduction in the size of periapical radiolucency at the end of the six-month follow-up in this current article is highly considerable.

This study describes 6 cases of endodontic overfilling with successful clinical outcomes during long-term (up to 35 years) radiographic follow-up. Successful endodontic treatment depends on proper shaping, disinfection, and obturation of root canals. Filling materials should completely fill the root canal space without exceeding the anatomical apex. Overfilling may occur when the filling material extrudes into the periapical tissues beyond the apex. The present case series describes 6 root canal treatments in which overfilling of root canal sealer and gutta-percha accidentally occurred. Patients\' teeth were periodically checked with periapical radiographs in order to evaluate the outcomes during long-term follow-up. All cases showed healing and progressive resorption of the extruded materials in the periapex. The present cases showed that if a 3-dimensional seal was present at the apical level, overfilling did not negatively affect the long-term outcomes of root canal treatment.

The endodontic management of immature permanent incisors in young children can be challenging. This case reported an avulsed immature maxillary central incisors that underwent complete endodontic obturation using mineral trioxide aggregate. A 10-year-old male who suffered a fall injury avulsed both his central incisors. The revascularization process was not possible due to patient compliance and geographic reasons. Mineral trioxide aggregate was utilized as a novel endodontic treatment. After one year post-injury, the teeth remained symptom-free, the clinical and radiographic follow-up showed evidence of healthy periodontium. How to cite this article: Al-Kahtani A. Avulsed Immature Permanent Central Incisors Obturated With Mineral Trioxide Aggregate: A Case Report. J Int Oral Health 2013; 5(3):88-96.

Pulpal and periradicular pathosis are the result of microbial, mechanical, or chemical invasion. Microorganisms are the main irritants of pulpal and periapical tissues. The goal of the obturation is to obtain a fluid-tight seal of the root canal system from its coronal aspect through its apical extent to preserve from the irritants.. Root apices have morphological irregularities in teeth with periapical lesions. Therefore, it is more difficult to produce hermetically apical stop with conventional guttapercha obturation techniques. This case report describes the treatment and six years follow-up of the teeth with large periapical lesion using MTA as apical filling material.