Retreatment of a Mandibular Molar with Chronic Apical Abscess and Internal Root Resorption with the GentleWave® Procedure: A 16-Month Clinical Case Report

Abstract

Introduction: Internal root resorption is a progressive loss of dentin in teeth with inflamed and possibly partially necrotic pulp tissue. If diagnosed at early stages, the process is halted by endodontic treatment. While endodontic treatment is the preferred treatment modality for internal root resorption, current standard endodontic techniques pose a challenge for cleaning, disinfection and obturation of these irregular and inaccessible areas, especially within the apical third. Background: In the present clinical case report, a 57-year-old female patient presented on emergency basis with pain and swelling of the lower left side of her jaw. Extensive internal root resorption and a large periradicular lesion of the mesial root were identified during radiographic assessment of the mandibular left first molar which had in part undergone endodontic therapy but without apparent treatment of the mesial root. Methods: Endodontic access was performed and purulent drainage was evident. After removal of the previous obturation material, the subject tooth underwent cleaning and disinfection of the root canal system using the GentleWave® Procedure. Obturation was completed with the absence of any clinically significant voids. Results: At the 16-month reevaluation the patient was asymptomatic, radiographic analysis showed complete healing of the periradicular lesion and extensive healing of the alveolar bone. The case reported provides evidence for the use of the GentleWave Procedure in internal apical root resorption cases, even when inaccessible and irregular areas provide a challenge for standard techniques.