An Interdisciplinary Approach for Management of Trauma-induced External Root Resorption: A Case Report with a Two-Year Follow-up

Abstract

Root resorption is largely pathologic and known to be initiated by several factors, including pulpal necrosis, trauma, periodontal treatment, orthodontic treatment, and bleaching agents. Incorrect diagnosis can lead to improper management and tooth loss. The treatment should involve the complete suppression of all the resorptive factors and the reconstruction of the defect using a suitable restorative material. The resorptive defect is often detected by the routine radiographic examination. A characteristic radiopaque line generally separates the image of the lesion from that of the root canal because the pulp remains protected by a thin layer of predentin until late in the process. Histopathologically, the lesions contain fibrovascular tissue with resorbing clastic cells adjacent to the dentin surface. Advanced lesions may also display fibro-osseous characteristics with deposition of ectopic bone-like calcifications. This case report presents extensive root resorption in the maxillary left lateral incisor and left canine in a 35-year-old patient. The defect was identified during the routine radiographic examination. The patient revealed a history of trauma 15 years back. Following the examination, the teeth were found to be vital and associated with the moderately deep periodontal pocket in the interdental region. The teeth were managed endodontically, and the resorption defect was restored with a biocompatible material after surgically elevating a flap. Periodontal management was also performed simultaneously by the surgical debridement of the area. Six-month postoperative radiograph revealed an arrest of the resorption and healing of the periodontal defect. Hence, an interdisciplinary management involving endodontic as well as periodontal treatment was performed that helped in saving the teeth with poor prognosis.