Comprehensive management of complex resorptive lesions: Report of two cases

Abstract

In the field of endodontics, the management of complex resorptive lesions demands innovative and precise interventions. This report delineates the comprehensive management of two distinct cases, each presenting unique challenges. The first case involved a 23-year-old male with hypothyroidism, presenting with pain and external cervical resorption with internal communication in his lower left front tooth. The case was diagnosed with pulp necrosis and asymptomatic apical periodontitis. The second case involved a 26-year-old female in good health, dissatisfied with the cosmetic appearance, and experiencing occasional pain from a previously treated upper front tooth with concurrent external apical and internal resorption. It was diagnosed as previously treated, with symptomatic apical periodontitis. These cases were notable for their complexity and the tailored approach to diagnosis and treatment, employing advanced techniques and materials, such as bioceramic materials, for optimal outcomes. The first case was approached through conventional endodontic disinfection, flap reflection, and the meticulous external management of the resorptive defect with bioceramic material, followed by restorative procedures. The second case required retreatment, including wide canal management, apex negotiation, and the establishment of an apical plug with bioceramic material, culminating in backfilling with thermoplasticized gutta-percha and subsequent prosthetic rehabilitation. Remarkably, both cases demonstrated successful healing and patient satisfaction at a 6-month follow-up, with radiographs and photographs evidencing the desired clinical outcomes. This report highlights the necessity of adaptability, precision, and the integration of innovative materials and techniques in endodontic practice to effectively address complex resorptive lesions. It underscores the significance of a comprehensive diagnostic and treatment framework that can guide clinical decision-making and enhance procedural outcomes in similar challenging scenarios. It contributes valuable insights and reinforces the imperative of detailed management in endodontic complexities.