complex resorption image

This case presents a unique challenge with extensive internal resorption that has perforated the lingual surface in the apical 1/3rd. This tooth has a guarded/fair prognosis due to the severity of resorption, but due to the extent of bone loss and high smile line, both a dental implant and an FPD would result in a poor esthetic outcome for this patient. How do we treat this tooth then? Calcium hydroxide therapy for several weeks is recommended to halt resorptive processes by killing clastic cells. In order to get a very dense temporary ‘fill’ in the resorption with calcium hydroxide, the apical 2 mm was obturated with gutta percha. The mid-root was filled with calcium hydroxide using a fair amount of pressure (which would cause massive extrusion if an apical gutta percha stop were not there). Note how this allowed the calcium hydroxide to completely fill the defect so we could feel confident that all residual clastic cells and tissue were being destroyed. After one month, the calcium hydroxide was removed, and BC Root Repair Material (Brasseler’s version of white MTA in a putty form) completely obturated the defect. Thinking outside of the box allowed for a unique approach and great outcome for this patient

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