Biodentine in management of invasive cervical resorption in maxillary canine

Abstract

Objectives: To present the outcome of surgical and non-surgical endodontic treatment of a maxillary left canine diagnosed with Class IV Invasive Cervical Resorption (ICR) after 1-year follow-up. Methods: The case report demonstrates the treatment of a maxillary left canine of a 58-year-old male patient who was referred to the Institute for Advanced Dentistry, The University of Hong Kong for the management of ICR. Clinical tests confirmed normal pulpal response, and periapical x-ray showed no periradicular pathology. CBCT examination confirmed the presence of ICR. The final diagnosis was Vital Pulp; Normal Apical Tissues with Class IV ICR of the maxillary left canine according to Heithersay’s classification. The patient had no history of pain or swelling. Non-surgical root canal treatment with concurrent periradicular surgery was initiated. After the completion of root canal instrumentation the full-thickness palatal flap was raised and periradicular resorptive tissue was removed, matrix band was placed and the root defect was filled with Biodentine (Septodont, France). The root canal was dressed with Ledermix paste (Riemser Pharma GmbH, Germany). Two weeks later the tooth was obturated with vertical warm compaction of gutta-percha and iRoot SP sealer (Innovative BioCeramix Inc, Burnaby, Canada), a fiber post was cemented and resin-bonded composite core was placed. Results: At 1-year follow-up the tooth was asymptomatic and functional. A new CBCT showed no signs of resorption with normal apical tissues. Conclusions: This case report demonstrates good clinical and radiographic outcomes in management of Class IV ICR with the use of Biodentine. Proper diagnosis, case selection can lead to the successful outcome, function and retention of teeth with Class IV ICR, but further clinical trials should be performed to support the use of Biodentine for management of cervical resorptions.