Multi-modal Restorative Endodontic Management to Rehabilitate and Salvage a Tooth with External Cervical Resorption and Iatrogenic Over Enlarged Root Canal with Widened Apex

The presence of both a pathologic external cervical resorption (ECR) and an iatrogenic over-enlarged root canal with a widened apex can significantly compromise the structural integrity of a tooth. Furthermore, regular restorative-endodontic management of the involved tooth poses many procedural challenges and difficulties. However, a multi-modal approach involving nonsurgical and surgical procedures with the application of advances in endodontics can help to manage and salvage such a tooth. This article aims to report on a case of multi-modal management with the application of cone-beam computed tomography, micro-endodontics, bioactive and biomimetic materials, and monobloc effect to manage and structurally rehabilitate and reinforce a tooth affected by both ECR and over enlarged canal with a widened apex. This multi-modal approach was applied with nonsurgical and surgical treatments to restoratively and endodontically manage the affected tooth. Clinical and radiographic follow-up of the tooth was uneventful and showed satisfactory and favorable outcomes.