Surgical-Endodontic Management of an Internal Root Resorption Lesion: A Case Report.

AIMS: Internal root resorption is a rare pathological condition characterized by progressive destruction of intraradicular dentin, often associated with dental trauma. This case report describes the diagnosis and management of extensive internal root resorption in a maxillary central incisor of a 19-year-old male patient with a history of dentoalveolar trauma eight years earlier. CASE REPORT: Clinical examination revealed tooth mobility, sinus tract formation, and negative pulp sensibility tests. Radiographic evaluation demonstrated extensive internal root resorption involving the middle third of the root with perforation to the external root surface. Initial conventional endodontic treatment was attempted; however, persistent intracanal bleeding prevented completion of the procedure. A combined surgical-endodontic approach was therefore performed, including flap elevation, removal of the apical root fragment, chemomechanical preparation, obturation with gutta-percha and AH Plus sealer, and sealing of the apical portion with Mineral Trioxide Aggregate (MTA). Clinical and radiographic follow-up was conducted over 24 months, demonstrating the absence of symptoms, mobility, and sinus tract, in addition to radiographic evidence of bone repair and tooth stability. CONCLUSION: The present case highlights the importance of long-term follow-up after dental trauma and demonstrates that even advanced cases of internal root resorption may be successfully managed through a multidisciplinary conservative approach.