Long-term interdisciplinary management of severe post-traumatic external inflammatory root resorption in an adolescent: A 10-year follow-up case report

Greta Lodienė¹ image, Ana Kostenkova2 image, Jolanta Siudikienė3 image

Highlights

Proper avulsion management and follow-up are vital, as rapid root resorption in children may cause early tooth loss and restrict restorative options in adolescence.

A multidisciplinary approach sustained a post-avulsed tooth with advanced resorption, preserving dentoalveolar integrity until implant restoration was possible.

A multidisciplinary approach sustained a post-avulsed tooth with advanced resorption, preserving dentoalveolar integrity until implant restoration was possible.

Abstract

External inflammatory root resorption is a pathologic process that commonly develops following mechanical damage to the cementum during traumatic dental injury. This case report presents the long-term interdisciplinary management of an avulsed immature maxillary central incisor complicated by severe external inflammatory root resorption. A 10-year-old patient presented with bleeding gingival tissue adjacent to the maxillary right central incisor. The medical history revealed that three years earlier, the patient had sustained an avulsion of tooth #11, which had been subsequently replanted. Clinical and radiographic examinations confirmed severe external inflammatory root resorption. Initial treatment consisted of root canal obturation with mineral trioxide aggregate followed by composite crown restoration. However, after nineteen months, the resorption progressed rapidly, resulting in crown fracture. Consequently, a decoronation procedure was performed. A removable orthodontic appliance was then used to preserve the alveolar bone space for nine years. At the age of 20, the patient underwent dental implant placement and restoration with a zirconia crown. This interdisciplinary and staged treatment approach ensured both functional stability and satisfactory aesthetic outcomes throughout all phases of management.

Keywords: Adolescent; Pediatric Dentistry; Root Resorption; Tooth Avulsion

Author Affiliations

  1. Assoc. Prof., Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Lithuania

  2. Master student, Faculty of Odontology, Lithuanian University of Health Sciences, Lithuania (Correspondence:annakostenkova7@gmail.com)

  3. Assoc. Prof., Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Lithuania

  1. Souza BDM, Dutra KL, Kuntze MM, Bortoluzzi EA, Flores-Mir C, Reyes-Carmona J, et al. Incidence of root resorption after the replantation of avulsed teeth: A meta-analysis. J Endod 2018;44:1216–1227
  2. Gregorczyk-Maga I, Kaszuba M, Olszewska M, Lichołai S, Iwaniec T, Kościelniak D, et al. Biomarkers of inflammatory external root resorption as a result of traumatic dental injury to permanent teeth in children. Arch Oral Biol 2019;99:82–91
  3. Abbott PV. Prevention and management of external inflammatory resorption following trauma to teeth. Aust Dent J 2016;61:82–94
  4. Andersson L, Bodin I, Sörensen S. Progression of root resorption following replantation of human teeth after extended extraoral storage. Endod Dent Traumatol 1989;5:38–47
  5. Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2020;36:331–42
  6. Al-Momani Z, Nixon PJ. Internal and external root resorption: Aetiology, diagnosis and treatment options. Dent Update 2013;40:102–112
  7. Lam R. Epidemiology and outcomes of traumatic dental injuries: A review of the literature. Aust Dent J 2016;61:4–20
  8. Holan G, Needleman HL. Premature loss of primary anterior teeth due to trauma: Potential short- and long-term sequelae. Dent Traumatol 2014;30:100–106
  9. Rodd HD, Malhotra R, O’Brien CH, Elcock C, Davidson LE, North S. Change in supporting tissue following loss of a permanent maxillary incisor in children. Dent Traumatol 2007;23:328–332
  10. Nagendrababu V, Chong BS, McCabe P, Shah PK, Priya E, Jayaraman J, et al. PRICE 2020 guidelines for reporting case reports in endodontics: Explanation and elaboration. Int Endod J 2020;53:922–947
  11. Safi Y, Ghaedsharaf S, Aziz A, Hosseinpour S, Mortazavi H. Effect of field of view on detection of external root resorption in cone-beam computed tomography. Iran Endod J 2017;12:179–184
  12. Jadav NM, Abbott PV. Dentists’ knowledge of dental trauma based on the International Association of Dental Traumatology guidelines: An Australian survey. Dent Traumatol 2022;38:374–380
  13. Bohner L, Hanisch M, Kleinheinz J, Jung S. Dental implants in growing patients: A systematic review. Br J Oral Maxillofac Surg 2019;57:397–406
  14. Sàndor GKB, Kainulainen VT, Queiroz JO, Carmichael RP, Oikarinen KS. Preservation of ridge dimensions following grafting with coral granules of 48 post-traumatic and post-extraction dentoalveolar defects. Dent Traumatol 2003;19:221–227
  15. Chen H, Teixeira FB, Ritter AL, Levin L, Trope M. The effect of intracanal anti-inflammatory medicaments on external root resorption of replanted dog teeth after extended extraoral dry time. Dent Traumatol 2008;24:74–78
  16. Pierce A, Lindskog S. The effect of an antibiotic/corticosteroid paste on inflammatory root resorption in vivo. Oral Surg Oral Med Oral Pathol 1987;64:216–220
  17. Malmgren B. Ridge preservation/decoronation. J Endod 2013;39:67–72
  18. Margunato S, Taşlı PN, Aydın S, Karapınar Kazandağ M, Şahin F. In vitro evaluation of ProRoot MTA, Biodentine, and MM-MTA on human alveolar bone marrow stem cells in terms of biocompatibility and mineralization. J Endod 2015;41:1646–652

Article Info

Contemp Pediatr Dent 2025:6(2):180-188

Received: 12 May 2025

Accepted: 11 August 2025

Online First: 28 August 2025

DOI: 10.51463/cpd.2025.22

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					Greta Lodiene, Ana Kostenkova, Jolanta Siudikiene. Long-term interdisciplinary management of severe post-traumatic external inflammatory root resorption in an adolescent: A 10-year follow-up case report. Contemp PediatrDent 2025:6(2):180-188

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