Management of Internal Root Replacement Resorption with Calcification Root Canal Using Guided Endodontic - A Case Report

Root resorption occurs gradually and silently, generally found with a history of trauma. This may occur in chronic pulpal inflammation, caries, or high-impact trauma. The pulp reacts defensively to stress by calcifying the root (calcific transformation). Intensity, duration, and pulp response to trauma affect the degree of calcification. IRRR (Internal Root Replacement Resorption) is a rare and complex dental condition characterized by the pathological replacement of the root canal dentin with bone-like tissue. This condition often results from chronic inflammation due to trauma, infection, or other etiological factors, leading to the obliteration of the root canal and posing significant challenges for conventional endodontic treatment.[1,2] The presence of calcification within the root canal further complicates the management, making it difficult to locate and negotiate the canal path.[3] Traditional endodontic approaches often fall short in effectively treating such cases, necessitating the exploration of advanced techniques. Guided endodontics is a promising solution for managing IRRR with calcified root canals. This innovative technique leverages CBCT (Cone Beam Computed Tomography) and 3D-printed surgical guides to enhance the precision and safety of endodontic procedures.[3-6] By providing a minimally invasive and highly accurate method for accessing calcified canals, guided endodontics ensures the preservation of tooth structure and reduces the risk of iatrogenic damage. The integration of digital planning and surgical guides has shown promising results in the treatment of complex endodontic cases, including those involving calcifications.[3,4,7] This case report details the successful management of a tooth affected by internal root replacement resorption with calcification using guided endodontic techniques. The clinical application of this innovative approach is demonstrated, highlighting its effectiveness in overcoming the challenges associated with IRRR and calcified canals. The outcomes of this case underscore the potential of guided endodontics to improve the prognosis of teeth with complex endodontic pathology.[8] This report contributes to the evidence supporting the use of advanced digital technologies in endodontic practice, offering insights into their practical implementation and benefits.