MASSIVE TOOTH RESORPTION

MASSIVE TOOTH RESORPTION: We have been waiting to post this case until after the restorative procedure has been done by the restorative dentist, but we couldn’t resist posting this case which we feel is quite interesting. This patient came to us as a 4th opinion (2 endodontists, 2 oral surgeons). Every time this tooth has been written off as non-saveable due to the extensive amount of tooth resorption. After very careful discussion with the patient, the decision was made to attempt saving it. The limiting factor to a favorable prognosis here is not the endodontics, but rather the restorative treatment to follow. We were able to remove all the resorptive tissue, complete the root canal, and cemented a fiber reinforced D.T. LightPost in the canal with proper mesial contour of the restoration. The clinical pictures represent pre and post-op from the same day. The post-op radiograph is actually a 3 month recall. As one can see, there has been a slight mesial bony defect and a minor black triangle in the papilla (sorry no pic available at this time). This patient is considering pre-prosthetic forced orthodontic extrusion per our recommendation to allow for an adequate margin for the prosthesis as well as to pull the periodontium coronally to aid in the esthetic outcome. Not an ideal case to start, but I think we managed pretty well and was able to help this patient save her tooth which she so desperately wanted to do!