Apical root-end filling with tricalcium silicate-based cement in a patient with diabetes mellitus: A case report

Introduction. The material used for root-end filling has to be biocompatible with adjacent periapical tissue and to stimulate its regenerative processes. Tricalcium silicate cement (TSC), as a new dental material, shows good seal- ing properties with dentin, high compression strengths and better marginal adaptation than commonly used root- end filling materials. Although optimal postoperative heal- ing of periapical tissues is mainly influenced by character- istics of end-root material used, it could sometimes be af- fected by the influence of systemic diseases, such as diabe- tes mellitus (DM). Case report. We presented apical heal- ing of the upper central incisor, retrofilled with TSC, in a diabetic patient (type 2 DM) with peripheral neuropathy. Standard root-end resection of upper central incisor was accompanied by retropreparation using ultrasonic retrotips to the depth of 3 mm and retrofilling with TSC. Post- operatively, the surgical wound healed uneventfully. How- ever, the patient reported undefined dull pain in the oper- ated area that could possibly be attributed to undiagnosed intraoral diabetic peripheral neuropathy, what was evalu- ated clinically. Conclusion. Although TSC presents a suit- able material for apical root-end filling in the treatment of chronic periradicular lesions a possible presence of sys- temic diseases, like type 2 DM, has to be considered in the treatment outcome estimation.