Cone Beam Computed Tomography as a Diagnostic Tool in the Diagnosis of an Iatrogenic Root Defect of a Root Canal Treated Maxillary Central Incisor with Periapical Lesion and Its Management by Re-apicectomy

Dental trauma often calls for a multi-faceted approach as they come along with complications such as pulp necrosis, canal calcifications, and periapical pathology. A conventional root canal therapy is the treatment of choice to address teeth injured by traumatic injuries. Moreover, the success of treatment can be undermined in cases with persistent pathology clubbed with iatrogenic errors. Iatrogenic root defects are exceptional, posing difficulty in diagnosis and treatment. This case report sheds light on the use of CBCT as a diagnostic tool in visualizing the scooped-out iatrogenic root defect of a root canal-treated right maxillary central incisor with periapical lesion. The iatrogenic root defect and periapical pathology were addressed by a second periapical surgery using MTA putty to construct a proper apical seal and a biologically based regenerative approach using platelet-rich fibrin and bone graft to revive the bone.