Management of Unusual Pattern of Internal Inflammatory Tooth Resorption and Periapical Cystic Lesion – A Unique Case Report

Abstract

Dental trauma is a challenge for dental integrity and can lead to various consequences, among which internal inflammatory root resorption can also be the fate of anterior teeth as they are commonly involved in traumatic events. The internal inflammatory root resorption occurs as a result of damage to the predentin due to trauma, plus root canal system becoming infected with bacteria. Trauma generates chronic inflammation, which leads to periapical inflammation and necrosis of epithelial cells, resulting in the formation of a cyst. The aim of the treatment approaches should be to assure complete biological healing and functional integration. This case report presents the unique characterization of traumatic consequences, including large periapical lesion and unique pattern of internal tooth resorption with intact apical barrier which was diagnosed by cone-beam computed tomography imaging and well managed by surgical intervention using mineral trioxide aggregate – both as a retrograde filling and tooth reinforcement material and sticky bone (platelet-rich fibrin + Bio-Oss) as a regenerative approach. The follow-up showed good results both clinically and radiographically. Thus, it can be concluded that endodontic reinforcement of thin roots due to internal resorption with intact apical barrier and surgical microendodontic procedure with regeneration is a potential therapeutic option in cases of traumatic injuries.