An unusual repair of perforating internal inflammatory root resorption; a case report of endodontic treatment

Internal inflammatory root resorption (IIRR) can occur as a serious complication of dental trauma which leads to progressive loss of the root structure. An early diagnosis could influence the therapeutic approach, but endodontic treatment becomes a challenge with a doubtful prognosis. The present report described an unusual clinical presentation of an IIRR with perforation resulting from a trauma four years previous. A 15-year-old female patient was presented to our service with pain in the maxillary incisor region. Intraoral radiography revealed a large radioloucent area compatible with IIRR, communicating with the periodontium in the middle third on the distal root face of the right central incisor. The root canal of the right central incisor was chemo-mechanically prepared. The calcium hydroxide (CH) intracanal medication was used and renewed periodically four times. The root canal was filled only in the cervical region to the level of resorption by the inverted gutta-percha cone technique. Clinically and radiographically, all follow-up examinations revealed an asymptomatic tooth, evidencing periapical tissue repair and new bone formation. The tooth remained asymptomatic 3 years afterwards. The present case report supports the idea of executing satisfactory intracanal decontamination by chemo-mechanical preparation, thus creating a favourable environment for tissue repair.

A novel ultrasonic tip for removal of filling material in flattened/oval-shaped root canals: a microCT study

Abstract The aim of this study was to evaluate the influence of a novel ultrasonic tip as an auxiliary method for removing filling material from flattened/oval-shaped canals. The null hypothesis tested was that this method does not influence removing the filling material in flattened/oval-shaped canals. Forty-five mandibular incisors were selected and randomly divided into three experimental groups (n = 15) according to different protocols for removing root canal filling material. Group R: Reciproc R25/.08, Group RC: Reciproc R25/.08 + Clearsonic tip, and Group CR: Clearsonic tip + Reciproc R25/.08. The teeth were scanned pre and post-operatively by means of a micro-computed tomography system. Data were analyzed using non-parametric Kruskal-Wallis and Dunn tests (p < 0.05). The percentage of residual root canal filling material between the experimental groups was examined. Statistically significant differences between the experimental groups were found in the root canal. Group R had the highest percentage of residual root canal filling material when compared with Groups RC and CR. The lowest percentage of residual root canal filling material was observed in Group CR. In the apical third of the root canal, statistically significant differences were found between the different protocols. The use of the ClearSonic tip followed by the Reciproc 25/.08 file to remove filling material resulted in the lowest percentage of residuals in the whole root canal and in the apical third.