Authors: Dmytro Viktorovych DOBROVOLSKYI, Natallia GEVKALIUK


Introduction. Intra-root resorption is one of the most poorly studied pathological conditions in modern dentistry today. According to a number of studies, the frequency of intra-root resorption detection, depending on the studied population, is 0.01-55 %. The aim of the study is to optimise the diagnosis and endodontic treatment of tooth 11 with suspected intra-root resorption. Materials and methods. Dental examination of the patient aged 15 years, determination of vitality signs of tooth 11 (cold test with Miracold plus -50oC), radiological examination (a series of targeted intraoral and extraoral X-rays of the tooth 11, orthopantomogram, cone beam computed tomography) were performed. Repeated endodontic treatment was performed using an electron microscope (Karl Kaps, Germany). Results and disscusion. A 15 year-old patient complained of recurrent pain in tooth 11. He received an acute injury in the area of the front teeth one year ago during boxing training. An objective examination revealed that tooth 11 was not discoloured, and there was no access to its crown. A temperature test (cold test with Miracold plus -50oC) showed no signs of vitality. Orthopantomogram of the root canal of tooth 11 showed loose filling material in the root canal, wide root apex, widening of the periodontal gap in the area of the tooth root apex. The targeted X-ray of tooth 11 shows the contours of the gutta-percha post, its apex being bent in the coronal pulp chamber, which indicates that the post was placed in retrograde position. Cone beam computed tomography showed periapical radiolucency at the apex of the causative tooth, without signs of root resorption, no intra-root resorption, and poor density of the filling material. The pulp chamber was accessed, the root canal was treated using hand instruments (K- and H-files) with constant disinfection with 5.25% sodium hypochlorite solution and solution activation using ultrasound. To clean the lubricated dentine root layer, a 2% EDTA solution was used, with subsequent neutralisation with a 5.25% sodium hypochlorite solution. The root canal apex was lined with cement (Bio MTA+) by Cerkamed, the other part – with thermoplastic gutta-percha system (DiaDent, Korea). Access to the root canal was sealed with Synergi D6 light-curing composite, colour A2. A follow-up visit within 6 months demonstrated clinical well-being, which was confirmed by a targeted radiography. Conclusions. The described clinical case suggests that the most optimal results of endodontic teeth treatment with intra-root resorption are observed when using an electron microscope with modern methods of root canal treatment and when filling it with biocompatible materials.

  • acute tooth trauma
  • endodontic treatment
  • intra-root resorption