Microscope Assisted Management of Symptomatic Internal Root Resorption in a Mandibular Premolar: 1 Year Outcome

Abstract

Although rare, internal resorption is a pathology that can severely compromise the structural integrity of a tooth if not diagnosed and treated early. In this case report, symptomatic internal resorption detected in the mandibular right second premolar (#45) of an 18-year-old patient was managed with operating microscope-assisted endodontic treatment performed under high magnification. Following clinical and radiographic evaluation, thorough canal disinfection was performed under the operating microscope. The resorptive defect was carefully filled with mineral trioxide aggregate (MTA) using the micro-apical placement (MAP) system. Root canal obturation was completed with a thermoplastic gutta-percha technique. Post-treatment, the patient’s symptoms completely resolved, and 12-month follow-up radiographs revealed no pathological findings in the periapical tissues. This case demonstrates that endodontic treatment performed under an operating microscope, using MTA placed with the MAP system and thermoplastic obturation techniques, can achieve successful clinical and radiographic outcomes in cases of symptomatic internal resorption.