Reparative Endodontic Treatment Of A Perforating Internal Root Resorption

The treatment of root resorption are mainly based on case reports, lacking systematic and specific diagnostic and treatment strategies, This case aims to provide assistance for dentists in diagnosing and treating root resorption. A 37-year-old asymptomatic female presented with a right mandibular second premolar showing a fractured-cusp and CBCT-confirmed mid-root perforations with periodontal ligament space widening. The diagnosis was a perforated IRR with asymptomatic pulpitis in tooth #45. Under local anesthesia, access cavity revealed calcified canals and active bleeding at perforations. Calcium hydroxide interappointment dressing 4 times over 11 months arrested inflammation. Root canal was prepared to size 35.06 Apical third obturated with iRoot SP (Innovative BioCeramix) and warm gutta-percha. Perforations sealed with iRoot BPplus. Fiber post and composite resin restored function. At 3-month,15-month follow-up, CBCT showed thickened root walls, and no resorption progression. The tooth remained asymptomatic with normal mobility and periodontal parameters. Due to pregnant, after 1-year of calcium hydroxide sealing, the absorption range in the root canal significantly decreased,.This indicates that calcium hydroxide sealing can reduce the perforation site. In addition, after 1-year of sealing, a pulp-like tissue formed at the root of the perforation site. Unfortunately, the collection of photos under the microscope was not comprehensive enough. For cases of extensive perforation in the middle of the root, good therapeutic effects can be achieved through treatment, but long-term follow-up is needed.