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Case Reports
. 2025 Aug 14:6:1604976.
doi: 10.3389/froh.2025.1604976. eCollection 2025.

Rescuing a "hopeless" tooth with severe internal resorption during orthodontic therapy: a case report

Wenjing Liu  1   2 , Xuezhong Xu  3 , Junqiang Wang  2 , Zhidan Li  4   5   6
Affiliations
Case Reports

Rescuing a "hopeless" tooth with severe internal resorption during orthodontic therapy: a case report

Wenjing Liu et al. Front Oral Health. .

Abstract

Root resorption is one of the leading complications that follows orthodontic treatment. It's an inflammatory process involving ischemic necrosis. Therefore, it is called orthodontically induced inflammatory root resorption (OIIRR). The purpose of this report is to present a case study of a patient in her 20s who experienced internal root resorption on two maxillary central incisors as a result of orthodontic treatment. Mineral trioxide aggregates (MTAs) were applied to the root resorption lesion to promote remineralization. A clinical and radiographic examination revealed that no radiolucency related to the resorptive lesion was found without any pathological symptoms after a 3-year follow-up.

Keywords: MTA; OIIRR; internal root resorption; root canal treatment; root resorption.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Radiological examination performed before orthodontic treatment. (A) Orthopantomogram. (B) Cephalometric radiograph.
Figure 2
Figure 2
Intro-oral photographs taken before orthodontic treatment. (A) Right lateral view. (B) Maxillary occlusal view. (C) Frontal view. (D) Mandibular occlusal view. (E) Left lateral view.
Figure 3
Figure 3
Oral examinations performed before root canal treatment. (A) Intro-oral photographs before root canal treatment. The white arrow points to the sinus on buccal mucosa. (B) An x-ray shows that in the region of the pulp chamber to the apical quarter of the root, an irregular low-density image area is observed in the upper right central incisor. In the root canal of the upper left central incisor, a semicircular low-density area is observed. (C) A CBCT examination of the initial dental status. The pulp chamber and the root canal of the upper right central incisor are absorbed, the walls of the root canal are thin, and the thickness is about 1 mm.
Figure 4
Figure 4
X-ray examination of the root canal treatment and a 3-year follow-up. (A) Working length determination. An x-ray shows that the working length is appropriate. (B) MTA is used for apical barrier and perforation repair. An x-ray shows that the apical 4 mm segment is tightly sealed with MTA as an apical barrier, and the lateral root perforation is repaired with MTA. (C) An x-ray taken right after root canal filling. The x-ray shows satisfactory root canal filling of the upper left central incisor and upper right central incisor. (D) At a 3-year follow-up, an x-ray reveals favorable prognosis in the upper left central incisor and upper right central incisor, with no periapical radiolucency observed.
Figure 5
Figure 5
Intro-oral photographs taken after orthodontic treatment. (A) Right lateral view. (B) Maxillary occlusal view. (C) Frontal view. (D) Mandibular occlusal view. (E) Left lateral view.
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