Nonsurgical Management of Periapical Lesion with External Root Resorption Followed by Orthodontic Treatment in Maxillary Lateral Incisor

The aim of this case report is to discuss the radiological outcome of a nonsurgical management of periapical lesion with external resorption followed by orthodontic treatment of the maxillary lateral incisor. A 33-year-old female reported with missing tooth in the maxillary anterior region as a result of surgical extraction of maxillary left canine tooth. Patient was referred for intentional root canal treatment in 22 followed by fixed prosthesis. The radiograph revealed external resorption in 21 and 22. After preparation of the access cavity, the necrotic pulp was removed and the canal irrigated using 5.25% sodium hypochlorite solution. The canal was then dried and packed with calcium hydroxide for 6 weeks. After removal of calcium hydroxide, canal was disinfected, dried and four millimetres of MTA orthograde filling was carried out. After 24 hrs, root canal was obturated with back fill using system B. At 1-3-6, month recall, the tooth was asymptomatic with no pain on percussion or palpation. Radiographic examination demonstrated continued thickening of root canal walls, root lengthening and apical closure.