Endodontic Management of the Maxillary Right Central Incisor with Extensive Internal Root Resorption without Perforation

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  • Tatsuya OHSUMI
    Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences
  • Shoji TAKENAKA
    Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences
  • Yuichiro NOIRI
    Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences

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  • 非穿孔型の広範な歯根内部吸収を認めた上顎右側中切歯の1症例

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Abstract

<p> Purpose: The pathogenesis of internal root resorption is not fully understood, and trauma and chronic pulpitis are considered to be major risk factors. Usually, this process is asymptomatic and is diagnosed by routine X-rays. This case report describes a very slow progression of internal absorption associated with traumatic injury. Dental cone beam CT (CBCT) results showed that the internal absorber had not been drilled out, so we decided on a non-surgical treatment. The combination of CBCT and microscopy gave a good prognosis.</p><p> Case: The patient was a 40-year-old man with the chief complaint of suspected internal absorption of #11, who was referred for examination by a general dental clinic. The patient had a history of trauma to the maxillary anterior teeth, having fallen from a bicycle about 15 years ago. The patient was less aware of symptoms and had no pain to date. In the buccal periapical tissue of #11, a sinus tract was observed. According to clinical findings and CBCT imaging, the case was diagnosed as apical abscess caused by irregular internal absorption. The treatment strategy was to treat the infected root canal, and after filling the root canal, we selected resin filling as the adhesive repair.</p><p> Conclusion: Since the internal absorption was widespread in the case, it was expected that the roots would become weakened. Moreover, the risk of root fracture was considered to be high. Therefore, the mechanical properties were improved by making the adhesive into a monobloc. The use of CBCT was shown to be extremely effective in the diagnosis and treatment of widespread internal absorption.</p>

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