PDF: Management of Internal Resorption with Perforation

Internal root resorption is a pathologic intraradicular process in which there is loss of dental hard tissue due to osteoclastic activity inside the root canal space

It is a rare lesion of permanent teeth, which might be caused due to caries, trauma, restorative procedures, etc. Because of its insidious pathology, it can extend to significant dimensions before being diagnosed and may lead to perforation to external root surface due to progressive odontoclastic activity. 

This article describes two case reports of surgical management of a perforating internal resorption in maxillary central incisors, managed by routine root canal treatment, followed by repair with Biodentine and mineral trioxide aggregate (MTA). 

About 12 to 24 months of follow-up demonstrated clinically asymptomatic and adequately functional tooth, with radiographic signs of healing. Care was taken to conserve the tooth structure and avoid further weakening of the alreadycompromised tooth. A tooth deemed to have a questionable prognosis was conserved and found to demonstrate satisfactory healing with no radiographic evidence of progressive resorption.

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