Cone-beam computed tomography-guided biomimetic management of extensive internal inflammatory resorption with histopathologic correlation

Internal inflammatory resorption is an uncommon pathologic condition characterized by progressive loss of intraradicular dentin due to clastic activity within inflamed pulp tissue. Early diagnosis is challenging because clinical symptoms are often absent until significant structural damage occurs. This case report describes the diagnosis and conservative management of extensive internal inflammatory resorption in a maxillary central incisor of a 30-year-old male patient. Cone-beam computed tomography (CBCT) was used to confirm the extent of the lesion and differentiate it from external resorption. Nonsurgical root canal treatment was performed to arrest the resorptive process. The structurally compromised cervical region was reinforced using polyethylene fiber integrated within a fiber-reinforced composite restoration. Histopathological examination revealed fibrovascular connective tissue with chronic inflammatory infiltrate and multinucleated giant cells consistent with odontoclastic activity. Follow-up at 6 months demonstrated satisfactory aesthetic and functional outcomes with radiographic stability. This case highlights the importance of CBCT in accurate diagnosis and emphasizes the role of biomimetic reinforcement strategies in preserving structurally weakened teeth.