Open apex (by Ilya Mer)

This upper canine #23 was retreated twice, the last time it happened approximately 3 years ago and you see the result. Percussion and palpation were moderate painful. There was significant leakage between composite cement and root canal wall and I had to remove a lot of caries with round bur from dentin canal walls . Apexification with MTA 4 weeks  after calcium hydroxide dressing.  Gelatinous sponges (Gelatamp, Roeko)  were used as a extraroot barrier in order to prevent the MTA getting out of root.

Preop images. Huge open apex and extension of guttapercha filling out of root canal
Fiberpost and cement were removed
extra-root barrier and MTA apical plug
MTA apical plug
Two fiberposts were cemented with dual-cure cement and build up was performed as well

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