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Extraoral Retrograde Root Canal Filling of an Orthodontic Induced External Root Resorption Using CEM Cement

Sanam Kheirieh, Mahta Fazlyab, Hassan Torabzadeh, Mohamad Jafar Eghbal
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Abstract

Inflammatory external root resorption (IERR) after orthodontic treatments is an unusual complication. This case report describes a non-vital maxillary premolar with symptomatic extensive IERR (with a crown/root ratio of 1:1) after receiving orthodontic treatment. The first appointment included drainage, chemo-mechanical preparation of the canal and intra-canal medication with calcium hydroxide (CH) along with prescription of analgesic/antibiotic. The subsequent one-week follow-up revealed the persistence of symptoms and formation of a sinus tract. Finally, extraoral endodontic treatment was planned; the tooth was atraumatically extracted and retrograde root canal filling with calcium enriched mixture (CEM) cement was placed followed by tooth replantation. Clinical signs/symptoms subsided during 7 days postoperatively. The sinus tract also resolved after one week. Six-month and one-year follow-ups revealed complete healing and a fully functional asymptomatic tooth. This case study showed favorable outcomes in a refractory periapical lesion associated with orthodontically induced extensive IERR. The chemical as well as biological properties of CEM cement may be a suitable endodontic biomaterial for these cases.


Keywords

Calcium Enriched Mixture; CEM Cement; Endodontics; External Inflammatory Root Resorption; Intentional Replantation; Oral Surgery; Orthodontics; Root Resorption



DOI: https://doi.org/10.22037/iej.v9i2.5599

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