Abstract
Aim: To describe complication management following regenerative endodontics.
Introduction: Regenerative endodontic procedures (REPs) are aimed
to treat apical periodontitis and promote root maturation
of immature necrotic teeth. Recently it was shown that REP may arrest
inflammatory external root resorption (IERR) in replanted
avulsed teeth. The purpose of this study is to describe a complication
of REP in which IERR had been developed after REP treatment.
Root Canal Treatment (RCT) using bio ceramic materials helped to arrest
the IERR.
Methods: An eight-and-a-half-year-old girl was referred for treatment after avulsion of tooth #9 which has been splinted in a
hospital for 2 weeks. After thorough examination tooth #9 was diagnosed as having necrotic pulp with symptomatic apical
periodontitis. The tooth was treated by REP using plasma rich fibrin (PRF) and restored. Eight months later, IERR has begun. RCT
using trichloroacetic acid (TCA) and mineral trioxide aggregate (MTA) plug was performed. The resorption area was treated with
bio ceramic putty material.
Results: 35 months after the treatment the tooth is functioning without signs and symptoms
Conclusions: The present case demonstrate a method in which a conservative RCT with some modification may arrest IERR using
TCA. IERR may develop long time following REP treatment. A thorough long follow-up is needed after REP. An early detection of
IERR may overcome this complication.
Key learning points: Although very rare, complication after REP such as IERR may occur, an early diagnosis of such complication
may be resolved by modified conservative RCT.
Keywords: Avulsion; Bio ceramics, External inflammatory root resorption; Regenerative endodontics, Trichloroacetic acid
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