Microapical surgery management of root resorption in anterior teeth caused by dental trauma: case report
Abstract
Root resorption (RR) is a common complication of traumatic dental injuries (TDIs), which could result in tooth loss and affect life in severe cases. The management of a traumatized tooth with RR remains a challenge for clinicians. In our presented cases, the impacted teeth had a history of trauma and underwent thorough non-surgical endodontic treatment; however, RR still occurred months later and could be observed through a periapical radiograph. Therefore, root canal therapy was performed under a dental microscope with a quick-setting calcium silicate cement to repair the RR site. After a long follow-up, the affected teeth showed almost complete healing of the periradicular tissues without sign of RR. This report demonstrates that external root absorption is typically a consequence of traumatized teeth. However, to date, there is still no effective method for its treatment. Here, we successfully applied microscopical surgery to the traumatized teeth experiencing root absorption and provided them with a new healing opportunity.
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References
Procopio SW, Matos HCA, de Oliveira PLE, de Andrade BAB, Agostini M, Esteves JC, et al. Development of a calcified odontogenic hamartoma following avulsion of a permanent central incisor. Dent Traumatol 2020; 36: 298–302. doi: 10.1111/edt.12519
Bilder L, Margvelashvili V, Sgan-Cohen H, Kalandadze M, Levin L, Ivanishvili R, et al. Traumatic dental injuries among 12- and 15-year-old adolescents in Georgia: results of the pathfinder study. Dent Traumatol 2016; 32: 169–73. doi: 10.1111/edt.12236
Gregorczyk-Maga I, Kaszuba M, Olszewska M, Licholai S, Iwaniec T, Koscielniak D, et al. Biomarkers of inflammatory external root resorption as a result of traumatic dental injury to permanent teeth in children. Archiv Oral Biol 2019; 99: 82–91. doi: 10.1016/j.archoralbio.2019.01.003
Mincik J, Urban D, Timkova S. Clinical management of two root resorption cases in endodontic practice. Case Rep Dent 2016; 2016: 9075363. doi: 10.1155/2016/9075363
Zare Jahromi M, Kalantar Motamedi MR. Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review. Restor Dent Endod 2019; 44: e32. doi: 10.5395/rde.2019.44.e32
Yoshpe M, Einy S, Ruparel N, Lin S, Kaufman AY. Regenerative endodontics: a potential solution for external root resorption (case series). J Endod 2020; 46: 192–9. doi: 10.1016/j.joen.2019.10.023
Saoud TM, Mistry S, Kahler B, Sigurdsson A, Lin LM. Regenerative endodontic procedures for traumatized teeth after horizontal root fracture, avulsion, and perforating root resorption. J Endod 2016; 42: 1476–82. doi: 10.1016/j.joen.2016.04.028
Gunraj MN. Dental root resorption. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 647–53.
Day PF, Duggal M, Nazzal H. Interventions for treating traumatised permanent front teeth: avulsed (knocked out) and replanted. Cochrane Database Syst Rev 2019; 2: CD006542. doi: 10.1002/14651858.CD006542.pub3
von Arx T. Apical surgery: a review of current techniques and outcome. Saudi Dent J 2011; 23: 9–15. doi: 10.1016/j.sdentj.2010.10.004
Fouad AF. Microbiological aspects of traumatic injuries. J Endod 2019; 45: S39–48. doi: 10.1016/j.joen.2019.05.011
von Arx T. [Mineral trioxide aggregate (MTA) a success story in apical surgery]. Swiss Dent J 2016; 126: 573–95.
Bastos JV, Ilma de Souza Cortes M, Andrade Goulart EM, Colosimo EA, Gomez RS, Dutra WO. Age and timing of pulp extirpation as major factors associated with inflammatory root resorption in replanted permanent teeth. J Endod 2014; 40: 366–71. doi: 10.1016/j.joen.2013.10.009
Hinckfuss SE, Messer LB. An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part I: timing of pulp extirpation. Dent Traumatol 2009; 25: 32–42. doi: 10.1111/j.1600-9657.2008.00727.x
Floratos S, Kim S. Modern endodontic microsurgery concepts: a clinical update. Dent Clin North Am 2017; 61: 81–91. doi: 10.1016/j.cden.2016.08.007
Levenson D. Review finds better endodontic surgery outcomes with microscope use. Evid Based Dent 2012; 13: 108. doi: 10.1038/sj.ebd.6400892
Setzer FC, Kohli MR, Shah SB, Karabucak B, Kim S. Outcome of endodontic surgery: a meta-analysis of the literature – part 2: comparison of endodontic microsurgical techniques with and without the use of higher magnification. J Endod 2012; 38: 1–10. doi: 10.1016/j.joen.2011.09.021
Kim HJ, Yu MK, Lee KW, Min KS. Surgical management of an accessory canal in a maxillary premolar: a case report. Restor Dent Endod 2019; 44: e30. doi: 10.5395/rde.2019.44.e30
Aidos H, Diogo P, Santos JM. Root resorption classifications: a narrative review and a clinical aid proposal for routine assessment. Eur Endod J 2018; 3: 134–45. doi: 10.14744/eej.2018.33043
Carnio J, Geraldeli S, White Jr C. Mineral trioxide aggregate combined with flap surgery for treatment of external root resorption. A long–term clinical case report. Clin Adv Periodontics 2015; 5: 254–9. doi: 10.1902/cap.2014.140023
Kumar R, Khambete N. Surgical operating microscopes in endodontics: enlarged vision and possibility. Int J Stomatol Res 2013; 2: 11–15.
Tsai CL, Ke MC, Chen YH, Kuo HK, Yu HJ, Chen CT, et al. Mineral trioxide aggregate affects cell viability and induces apoptosis of stem cells from human exfoliated deciduous teeth. BMC Pharmacol Toxicol 2018; 19: 21. doi: 10.1186/s40360-018-0214-5
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