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Varna Medical Forum

Surgical or non-surgical root canal treatment in teeth with perforating internal resorption

Trayan Marinov, Aleksandrina Varbanova, Marina Yordanova, Siana Atanasova, Maya Doychinova

Abstract

Internal resorption is a rare condition that is characterized by the destruction of intraradicular dentin and dental tubes due to clastic activity that can be followed by perforating the root and communication of the endodontium with the periodontium. The aim of our literature review is to analyze the different clinical approaches of root canal treatment of teeth with perforating internal resorption and to give predictable and safe protocols of the treatment plan. In recent years, MTA has been proven to be the material of choice for the treatment of perforations of a different nature in the endodontic practice. There are two basic approaches to its application in such situations - surgical or non-surgical. Surgical methods are applied when conservative ones have done what they can or are not feasible - lack of healing process, inability to drain the canal or non-stop bleeding resulting from granulation tissue in the perforation lesion. Depending on the location of the perforating internal resorption, the apical or coronal part of the root, should be treated differently. Perforations in the coronary part should be treated non-surgically with a hybrid technique - obturating the perforation by conventional means - gutta-percha and a sealer, within the inter-nal resorbtion - MTA. Cases of internal perforating resorptions in the apical part of the root canal should be treated with surgical access even in the presence of evidence of a conservative approach. In conclusion, endodontic treatment of teeth with perforating internal resorption is a challenge and requires the use of all the benefits of modern endodontics. The imaging study with CBCT can provide highly important information defining the treatment plan that conventional X-ray methods cannot show.

Keywords

perforating internal resorption; root canal treatment; MTA

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References

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DOI: http://dx.doi.org/10.14748/vmf.v6i0.5455

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