Management of Inflammatory External Root Resorption by Using Calcium-enriched Mixture Cement: A Case Report

Abstract

Introduction Inflammatory external root resorption is one of the major complications after replantation of avulsed teeth. Here we report a case of inflammatory external root resorption in a maxillary left central incisor in an 11-year old male patient that was managed and treated by using calcium enriched mixture (CEM) cement. Methods The patient’s chief complaint was mobility of avulsed and replanted maxillary left central incisor and pain in chewing on left central and lateral incisors. Radiographic examination showed progressive inflammatory external root resorption of the left central incisor with an inadequately obturated root canal treatment. Both teeth were immature and had periapical radiolucencies. Both teeth were irrigated copiously with 2.5% NaOCl and obturated with CEM cement. However, the central incisor was treated with calcium hydroxide 6 weeks before CEM cement obturation. Results The clinical and radiographic examinations at 3-, 6-, 12-, 24-, and 40-month follow-up showed that treated teeth were functional with normal mobility, the progression of the inflammatory external root resorption ceased, the resorptive lacunae were filled with newly formed bone, and periapical radiolucencies healed. Conclusions Considering the biological properties of CEM cement, especially its alkalinity and sustained calcium hydroxide release, using this novel cement for treatment of inflammatory external root resorption and obturation of immature necrotic teeth might be an applicable choice.