Management of merged external/internal root resorption using CEM cement: a case report.
Abstract
Chronic pulpal inflammation and infection are the main predisposing factors for internal and external root resorption (IRR & ERR); however, merging of IRR and ERR is a rare lesion which rigorously alters the anatomy of root canals. This study reports a case of merged IRR and ERR in an asymptomatic maxillary left central incisor in a 33-year old Caucasian woman that was managed by one-visit root canal therapy (RCT) using calcium-enriched mixture (CEM) cement. Radiographic examination showed a short root with under-filled root canal obturation associated with ERR/IRR and an apical lesion. After thorough chemo-mechanical preparation, the root canal was obturated with CEM cement; one week later, the access cavity was permanently restored. Clinical/radiographic examinations at 1-year follow-up revealed uneventful healing, reestablishment of lamina dura and stabilization of the resorptive defects. The treatment outcome demonstrates that one-visit RCT using CEM cement may be a viable treatment option in cases with merged external/internal root resorption. Further clinical trials with a larger number of cases are suggested to document a higher level of evidence.
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29. Parisay I, Ghoddusi J, Forghani M. A review on vital pulp therapy in primary teeth. Iran Endod J. 2015;10(1):6–15.
30. Yazdani S, Jadidfard MP, Tahani B, Kazemian A, Dianat O, Alim Marvasti L. Health Technology Assessment of CEM Pulpotomy in Permanent Molars with Irreversible Pulpitis. Iran Endod J. 2014;9(1):23–9.
31. Asgary S, Ahmadyar M. Vital pulp therapy using calcium-enriched mixture: An evidence-based review. J Conserv Dent. 2013;16(2):92–8.
32. Rahimi , Mokhtari , Shahi , Kazemi , Asgary , Eghbal MJ, Mesgariabbasi M, Mohajeri D. Osseous reaction to implantation of two endodontic cements: Mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM) Med Oral Patol Oral Cir Bucal. 2012;17(5):e907–11.
33. Samiee M, Eghbal MJ, Parirokh M, Abbas FM, Asgary S. Repair of furcal perforation using a new endodontic cement. Clin Oral Investig. 2010;14(6):653–8.
34. Asgary S, Ahmadyar M. One-visit endodontic retreatment of combined external/internal root resorption using a calcium-enriched mixture. Gen Dent. 2012;60(4):e244–8.
35. Niu LN, Jiao K, Wang TD, Zhang W, Camilleri J, Bergeron BE, Feng HL, Mao J, Chen JH, Pashley DH, Tay FR. A review of the bioactivity of hydraulic calcium silicate cements. J Dent. 2014;42(5):517–33.
2. Andreasen JO. External root resorption: its implication in dental traumatology, paedodontics, periodontics, orthodontics and endodontics. Int Endod J. 1985;18(2):109–18.
3. Tronstad L. Root resorption--etiology, terminology and clinical manifestations. Endod Dent Traumatol. 1988;4(6):241–52.
4. Heithersay GS. Invasive cervical resorption: an analysis of potential predisposing factors. Quintessence Int. 1999;30(2):83–95.
5. Mohammadi Z, Jafarzadeh H, Shalavi S, Yaripour S, Sharifi F, Kinoshita JI. A Review on Triple Antibiotic Paste as a Suitable Material Used in Regenerative Endodontics. Iran Endod J. 2018;13(1):1–6.
6. Cvek M. Treatment of non-vital permanent incisors with calcium hydroxide. II. Effect on external root resorption in luxated teeth compared with effect of root filling with guttapucha. A follow-up. Odontol Revy. 1973;24(4):343–54.
7. Heling I, Gorfil C, Slutzky H, Kopolovic K, Zalkind M, Slutzky-Goldberg I. Endodontic failure caused by inadequate restorative procedures: review and treatment recommendations. J Prosthet Dent. 2002;87(6):674–8.
8. Rosenberg B, Murray PE, Namerow K. The effect of calcium hydroxide root filling on dentin fracture strength. Dent Traumatol. 2007;23(1):26–9.
9. Cvek M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Endod Dent Traumatol. 1992;8(2):45–55.
10. Mohammadi Z, Shalavi S, Yazdizadeh M. Antimicrobial activity of calcium hydroxide in endodontics: a review. Chonnam Med J. 2012;48(3):133–40.
11. Figini L, Lodi G, Gorni F, Gagliani M. Single versus multiple visits for endodontic treatment of permanent teeth: a Cochrane systematic review. J Endod. 2008;34(9):1041–7.
12. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J. 2008;41(2):91–9.
13. Prati C, Gandolfi MG. Calcium silicate bioactive cements: Biological perspectives and clinical applications. Dent Mater. 2015;31(4):351–70.
14. Kumar SS, Kumar NS, Karunakaran JV, Nagendran S. Management of invasive cervical resorption in a maxillary central incisor. J Pharm Bioallied Sci. 2015;7(Suppl 2):S712–7.
15. Asgary S, Eghbal MJ, Parirokh M, Ghoddusi J. Effect of two storage solutions on surface topography of two root-end fillings. Aust Endod J. 2009;35(3):147–52.
16. Agamy HA, Bakry NS, Mounir MM, Avery DR. Comparison of mineral trioxide aggregate and formocresol as pulp-capping agents in pulpotomized primary teeth. Pediatr Dent. 2004;26(4):302–9.
17. Asgary S, Eghbal MJ, Ehsani S. Periradicular regeneration after endodontic surgery with calcium-enriched mixture cement in dogs. J Endod. 2010;36(5):837–41.
18. Asgary S, Nosrat A, Seifi A. Management of inflammatory external root resorption by using calcium-enriched mixture cement: a case report. J Endod. 2011;37(3):411–3.
19. Asgary S, Fazlyab M. Surgical repair of invasive cervical root resorption with calcium-enriched mixture cement: a case report. Gen Dent. 2015;63(1):37–40.
20. Asgary S, Nosrat A. Conservative Management of Class 4 Invasive Cervical Root Resorption Using Calcium-enriched Mixture Cement. J Endod. 2016;42(8):1291–4.
21. Komabayashi T, Zhu Q. Internal and external resorption in a lower molar with an associated endodontic-periodontic lesion: a case report. Aust Endod J. 2012;38(2):80–4.
22. Ahangari Z, Nasser M, Mahdian M, Fedorowicz Z, Marchesan MA. Interventions for the management of external root resorption. Cochrane Database Syst Rev. 2015;24(11):CD008003.
23. Carrotte P. Endodontics: Part 9. Calcium hydroxide, root resorption, endo-perio lesions. Br Dent J. 2004;197(12):735–43.
24. Mente J, Geletneky B, Ohle M, Koch MJ, Friedrich Ding PG, Wolff D, Dreyhaupt J, Martin N, Staehle HJ, Pfefferle T. Mineral trioxide aggregate or calcium hydroxide direct pulp capping: an analysis of the clinical treatment outcome. J Endod. 2010;36(5):806–13.
25. Petrou MA, Alhamoui FA, Welk A, Altarabulsi MB, Alkilzy M, Splieth C. A randomized clinical trial on the use of medical Portland cement, MTA and calcium hydroxide in indirect pulp treatment. Clin Oral Investig. 2014;18(5):1383–9.
26. Sarris S, Tahmassebi JF, Duggal MS, Cross IA. A clinical evaluation of mineral trioxide aggregate for root-end closure of non-vital immature permanent incisors in children-a pilot study. Dent Traumatol. 2008;24(1):79–85.
27. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action. J Endod. 2010;36(3):400–13.
28. Utneja S, Nawal RR, Talwar S, Verma M. Current perspectives of bio-ceramic technology in endodontics: calcium enriched mixture cement - review of its composition, properties and applications. Restor Dent Endod. 2015;40(1):1–13.
29. Parisay I, Ghoddusi J, Forghani M. A review on vital pulp therapy in primary teeth. Iran Endod J. 2015;10(1):6–15.
30. Yazdani S, Jadidfard MP, Tahani B, Kazemian A, Dianat O, Alim Marvasti L. Health Technology Assessment of CEM Pulpotomy in Permanent Molars with Irreversible Pulpitis. Iran Endod J. 2014;9(1):23–9.
31. Asgary S, Ahmadyar M. Vital pulp therapy using calcium-enriched mixture: An evidence-based review. J Conserv Dent. 2013;16(2):92–8.
32. Rahimi , Mokhtari , Shahi , Kazemi , Asgary , Eghbal MJ, Mesgariabbasi M, Mohajeri D. Osseous reaction to implantation of two endodontic cements: Mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM) Med Oral Patol Oral Cir Bucal. 2012;17(5):e907–11.
33. Samiee M, Eghbal MJ, Parirokh M, Abbas FM, Asgary S. Repair of furcal perforation using a new endodontic cement. Clin Oral Investig. 2010;14(6):653–8.
34. Asgary S, Ahmadyar M. One-visit endodontic retreatment of combined external/internal root resorption using a calcium-enriched mixture. Gen Dent. 2012;60(4):e244–8.
35. Niu LN, Jiao K, Wang TD, Zhang W, Camilleri J, Bergeron BE, Feng HL, Mao J, Chen JH, Pashley DH, Tay FR. A review of the bioactivity of hydraulic calcium silicate cements. J Dent. 2014;42(5):517–33.
Published
2018-11-23
How to Cite
MIRMOHAMMADI, Hesam; ASGARY, Saeed.
Management of merged external/internal root resorption using CEM cement: a case report..
Journal of Oral Research, [S.l.], v. 7, n. 8, p. 318-322, nov. 2018.
ISSN 0719-2479.
Available at: <https://www.joralres.com/index.php/JOralRes/article/view/joralres.2018.080>. Date accessed: 19 apr. 2024.
doi: https://doi.org/10.17126/joralres.2018.080.
Issue
Section
Cases
Keywords
calcium-enriched mixture cement; dental cements; endodontics; root canal therapy; root resorption.
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