Multidisciplinary Conservative Approach to Restore Mutilated Immature Maxillary Central Incisor with an Unusual Foreign Object in the Root Canal Space - A Rare Case Report

Abstract

Restoration of mutilated tooth with immature apex in a young patient presents challenge in complete biomechanical preparation, achieving apical seal and post endodontic restoration. The present article describes three years follow up of successfully managed mutilated maxillary central incisor with an immature apex and evidence of foreign object in the root canal space followed by its aesthetic rehabilitation. After retrieval of foreign object from the root canal, root end maturation was accomplished by using combination of deproteinized bovine bone mineral (Bio-Oss) and Enamel Matrix Derivative (EMD). To achieve optimum gingival attachment with alveolar bone support, mutilated tooth was extruded using removable orthodontic appliance and restored functionally using fibre post. Finally both traumatised maxillary incisors were rehabilitated aesthetically with full coverage acrylic crowns. At three years follow up, the patient had no clinical symptoms or any radiographic sign and the healing of periapical lesion and formation of the apex was observed.

Keywords

• bio-oss
• enamel matrix derivative
• immature apex
• removable orthodontic appliance