INTERNAL RESORPTION IN THE CERVICAL AND MIDDLE THIRD OF THE LEFT UPPER INCISOR

Abstract

Patient, JTRM, Caucasian, female, 25 years old, without systemic problems, was referred to the private office of an endodontics specialist for treatment of tooth 21. Periapical radiographic examination showed the presence of internal root resorption in the cervical and middle third of the root canal, with well-defined boundaries, ovoid and apparent appearance without communication with the adjacent bone. A cone beam computed tomography scan was requested to analyze in greater detail the location and whether there was communication with the periodontium. After coronary opening and medium cervical preparation with ProDesign S #30.10 file, the apical-mechanical chemical preparation, as measured by the CRD, was performed with Kerr #50, #55 and #60 files, and then the irrigation protocol was carried out through the Easy Clean plastic file in reciprocating motion, with cycles of 3 x 20 s of 2.5% sodium hypochlorite,  3 x 20 s of 17% trisodium EDTA and again 3 x 20 s with sodium hypochlorite. The root canal was dried with 60-inch absorbent paper tips and the canal filling was performed by the modified hybrid Tagger technique (main cone of gutta-percha associated with BIO-C Sealer filling cement. It is concluded that early detection and a correct differential diagnosis are essential for the successful management of internal resorption. The goal of endodontic therapy is the removal of inflammatory tissue and three-dimensional shaping, cleaning and filling of the enlarged canal space, while also avoiding unnecessary dentin removal that could further weaken the remaining tooth structure.