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.
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