22/02/2026
Case Study:
Extruding Metapex (calcium hydroxide paste with iodoform) beyond the root apex is a relatively common occurrence in endodontics.
An extrusion of Metapex beyond apex into furcation area occurred during the interim dressing of this case. While iodoform-based pastes are known to be resorbable, this instance showed remarkably fast clearance completely resorbed by day 3.
The patient reported only mild discomfort on the first day, which resolved quickly without intervention. A great reminder of the body’s healing efficiency.
In most cases, don't panic. If the extrusion is there and the patient is asymptomatic, the standard protocol is "observe and monitor." The good news is that Metapex is resorbable. Unlike permanent root canal sealers or gutta-percha, the body’s macrophages and giant cells will gradually break down and "eat" the extruded material.
Most studies show that extruded Metapex usually resorbs within one to six months, depending on the volume.
However, if the patient reports persistent numbness or severe, worsening pain, further intervention may be needed especially if :
Iodoform Sensitivity: Since Metapex contains iodoform, a patient with an iodine allergy might have an adverse reaction.
Nerve Proximity: If the material is extruded into the inferior alveolar nerve canal or the maxillary sinus, it can cause more significant issues like paresthesia (numbness) or localized sinusitis.
Foreign Body Reaction: If a very large "glob" is extruded, the body might wall it off, leading to a delayed healing process or a persistent radiopacity on X-rays.
