Perio Contest 2018/ 20 April 2018/

Case 46 | Perio Contest 2018 | Indonesia

Dr Calvin Kurnia

A SURGICAL INTERVENTION FOR PERSISTENT PERIAPICAL LESION AND EXTERNAL ROOT RESORPTION

*Calvin Kurnia, DDS. (Indonesia)
**Ovilya Septy Hutami Pasaribu, DDS.
Under supervision from ***Dr. drg. Ira Komara, Sp.Perio(K)
*Resident of Periodontology, University of Padjadjaran, Bandung
**Resident of Conservative Dentistry, University of Padjadjaran, Bandung
***Lecturer of Periodontology, University of Padjadjaran, Bandung

Chief Complaints:

Female (51 y.o.) initially felt tenderness in left central incisor while biting a food and slight mobile, after root canal treatment patient was reffered to department of periodontology because of persistent periapical lesion and external root resorption.

Treatment Objectives:
To cease the progression of apical inflammation and external root resorption

Treatment Results:
Post-operative (3 months) radiograph evaluation showed radiopacity in apical, no sign of any further inflammation and root resorption.

Clinical Evaluation
• Gingival recession 21 (Class I Miller)
• Grade I mobility 11 and 21
• No pocket abnormalities
• No Bleeding on Probing
• Tooth Vitality (-); Tenderness to Percussion (+)
• Composite fillings in both 11 and 21
• Patient wearing a removable denture

Radiograph Evaluation
• Radiolucency in apical 21 (sign of periapical lesion and
external root resorption)
• Crown to root ratio 1:1

Treatment Planning
a. Preliminary Phase: –

b. Initial Phase:
– Inform consent
– Oral Hygiene instruction
– Scalling and Root Planing
– Temporary wire splint 11-21
– Evaluation of initial phase response

c. Surgical Phase:
– Endodontic Treatment 21
– Root Resection 21

d.Restorative Phase:
– Splint denture
– Restorative phase evaluation

e. Maintenance Phase:
– Home care
– Periodic recall 3 and 6 month
– Evaluation of maintenance phase