Europian Society Of Endodontics Biennial Congress Budapest, Budapest, Hungary, 7 - 10 September 2022, pp.26
Non-surgical management of external root resorption caused by orthodontic treatment: a case report
Şerife
Seray ATEŞ, Özgür İlke ATASOY ULUSOY, İlke
Gaye SAVUR
Gazi Univerversity, Faculty of Dentistry, Department of
Endodontics
Aim: The aim
of this case report is to describe the treatment of a 32-year-old patient who suffered from
external inflammatory root resorption of the permanent mandibular first
premolar following orthognathic surgery.
Introduction: The non-surgical management of external resorption includes calcium hydroxide dressing of root canal until the healing
signs around the resorptive defect were observed in the radiographic evaluation.
Following this procedure, tricalcium silicate cements are suggested for orthograde filling of the root canal as a treatment option.
Case
Presentation: A
32-year-old male patient was
referred to Endodontic Department after radiological examination (fig.1a,1b,1c). The
patient had no complaint about the related tooth. As a result of the detailed radiological and clinical
examination, tooth #44 was
diagnosed with external inflammatory root resorption. It was thought that
resorption developed due to trauma during orthognathic surgery or orthodontic movement. The
root canal was chemomechanically instrumented using stainless steel K-files and rotary instruments also irrigated with 2.5% sodium hypochlorite (NaOCl). Irrigation solution was activated by ultrasonic energy. Calcium hydroxide (CaOH2) was used as an intracanal
medicament (fig.2) and a multi-visited treatment protocol was
applied until the healing signs were observed radiographically (fig.3). After inducing hard tissue
formation, the root canal including resorptive defect was filled using MTA, and the coronal half of the root canal with gutta-percha cones and resin based sealers. The tooth was restored using composite resins.
Discussion: Evidence of radiological and
clinical positive outcome supports the application of long-term calcium hydroxide dressing of the root canal including external
resorption. Additionally, the use of MTA as a biomaterial may lead to an
increase to survival time of tooth.
Conclusion
& Clinical Relevance: The post-operative periapical
radiograph showed that the canal was obturated properly. The patient was
recalled after 6 months (fig.6)
and 12 months (fig.7). Clinical evaluation revealed that the tooth was asymptomatic. The formation of new periodontal attachment and the signs of bone healing were observed in the follow-up radiographic images.
References
Trope, M., Moshonov, J., Nissan, R., Buxt, P., &
Yesilsoy, C. (1995). Dental Traumatology, 11(3), 124–128.
Int J
Clin Exp Pathol 2014 May 15;7(6):3338-46.