Dr. Mary Dabuleanu from Dabuleanu Dental and Dr. Suham Alexander provided this quick initial response:
Root canal sealers or cements play an important role in endodontic treatment such as:
- filling irregularities between the filling material and root canal walls
- filling accessory canals and foramina of canals
- binding agent for gutta percha or other core material to the dentin
- illustrates presence of areas of resorption, internal shape of canals, apical foramina and other structures due to its radiopaque properties
- lubricating the canal space during placement of gutta percha cones
According to the American Dental Association (ADA), overfilling by more than 2mm past the radiological apex represents a technical error ascribable to over-instrumentation, inadequate measuring, or a lack of an apical stop.
Over-instrumentation of canals can lead to the extrusion of infected debris as well as cement beyond the apex of a tooth which may hinder tissue healing in the periapical region. More often than not, any irritation that occurs is transitory with subsequent resorption of excess material and complete healing within a few months. However, the prognosis ultimately depends upon the reaction of the periradicular tissues to the obturation material and is dependent on the interaction between the extruded root canal filling materials and the host’s defences.
Additionally, it is important to note that overfilled or overextruded root canal filling materials may migrate or be displaced and cause symptoms such that surgical intervention is warranted, at times, to achieve a satisfactory resolution and long-term outcome.
- Chhabra A, Teja, TS, Jindal V, Singla MG, Warring K. Fate of Extruded Sealer: A Matter of Concern. J Oral Health Comm Dent 2011;5(3) 168-172.
- Santoro V, Lozito P, De Donno A, Grassi FR, Introna F. Extrusion of Endodontic Filling Materials: Medico-Legal Aspects. Two Cases. The Open Dentistry Journal. 2009(3) 68-73.
- Sari S, Duruturk L. Radiographic evaluation of periapical healing of permanent teeth with periapical lesions after extrusion of AH Plus sealer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104:e54-e59
- Ektefaie MR, David HT, Poh CF. Surgical Resolution of Chronic Tissue Irritation Caused by Extruded Endodontic Filling Material. J Can Dent Assoc 2005; 71(7): 487-90.
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