Retreatment of a resected tooth associated with a large periradicular lesion by using a triple antibiotic paste and mineral trioxide aggregate: a case report with a thirty-month follow-up

J Endod. 2009 Nov;35(11):1603-6. doi: 10.1016/j.joen.2009.07.019. Epub 2009 Sep 23.


Introduction: Trauma to the teeth and supporting structures is a frequent problem among children. Endodontic treatment is necessary for 41.3% of traumatized teeth. Two of the most important criteria for successful endodontic treatment are the elimination of microorganisms and apical sealing. A combination of antibiotic drugs (metranidozole, ciprofloxacin, and minocycline) is used to eliminate target bacteria, which are possible sources of endodontic lesions. For cases in which apical sealing is difficult, specific materials to plug the apical region have been advocated. Mineral trioxide aggregate (MTA) has become the material of choice because it is biocompatible and has bacteriostatic action.

Methods: This case report describes the nonsurgical retreatment of a traumatized tooth that had already undergone unsuccessful apical resection associated with a large periradicular lesion. A combination of antibiotic drugs was used as an intracanal medicament, and MTA was used to obtain a hermetic seal of the lateral tooth that had undergone unsuccessful apical resection.

Results: On follow up, the tooth was clinically and radiographically asymptomatic for 30 months.

Conclusions: The results of this case show that MTA and triple antibiotic paste can be used clinically in the treatment of an unsuccessfully resected tooth associated with a large periradicular lesion.

Publication types

  • Case Reports

MeSH terms

  • Aluminum Compounds / therapeutic use*
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Apicoectomy / adverse effects*
  • Calcium Compounds / therapeutic use*
  • Child
  • Ciprofloxacin / administration & dosage
  • Cuspid / pathology
  • Drug Combinations
  • Follow-Up Studies
  • Humans
  • Incisor / injuries
  • Male
  • Metronidazole / administration & dosage
  • Minocycline / administration & dosage
  • Oxides / therapeutic use*
  • Periapical Diseases / therapy*
  • Retreatment
  • Root Canal Filling Materials / therapeutic use*
  • Root Canal Irrigants / therapeutic use
  • Root Canal Obturation / methods
  • Root Canal Preparation / methods
  • Silicates / therapeutic use*
  • Tooth Fractures / therapy


  • Aluminum Compounds
  • Anti-Bacterial Agents
  • Calcium Compounds
  • Drug Combinations
  • Oxides
  • Root Canal Filling Materials
  • Root Canal Irrigants
  • Silicates
  • mineral trioxide aggregate
  • Metronidazole
  • Ciprofloxacin
  • Minocycline