Non-surgical endodontic retreatment of upper central incisor with apical periodontitis and external inflammatory root resorption: a case report

Abstract

Failures associated with primary endodontic treatment are related to the persistence of apical periodontitis. As an inflammatory response to bacteria and their products, external inflammatory resorption is initiated by cementum resorption and is present in most teeth with radiographic signs of apical periodontitis. Non-surgical endodontic retreatment consists in removing the filling material from the root canal system in order to reshape and disinfect it. The aim of the study is to present a case of non-surgical endodontic retreatment involving an upper right central incisor with signs of apical periodontitis and external inflammatory resorption, using different techniques and materials. Patient, age 25, with a history of trauma as a child, in units 11 and 12, having undergone root canal treatment in both. CBCT showed a hyperdense image in the root canal, suggestive of filling material, a hypodense image in the root apex, suggestive of periapical lesion and an irregularity in the root apex, compatible with external inflammatory resorption was also noticed. Magnification, gates drills, manual and mechanized files and ultrasonic inserts were used to perform root canal desobturation. The chemical-mechanical preparation involved the use of files and sodium hypochlorite. An irrigation protocol was also executed. Through Tagger’s hybrid obturation technique and AH Plus filling cement, the root canal was filled. The patient was referred to the oral rehabilitation clinics and, after 6 months, clinical, radiographic and tomographic controls were performed, showing regression of the presented conditions. Non-surgical endodontic retreatment proved to be an effective alternative for cases of chronic apical periodontitis associated with external inflammatory resorption.