Nonsurgical Management of Perforating Internal Root Resorption in Maxillary Invaginated Lateral Incisor Using Cold Ceramic.

The clastic activity results in internal root resorption (IRR), characterized by the progressive destruction of the surrounding dental hard tissues. This case reports perforating IRR in an advanced stage on a maxillary dens invaginated lateral incisor in a 13-year-old patient who completed orthodontic treatment 6 months ago. The perforating IRR was initially detected by periapical radiographs, and CBCT was used to accurately diagnose with full detail, enabling treatment planning and the identification of the extension and regions affected in the resorption lesion. A conservative internal approach was chosen for this case's management due to the periodontium's health and the absence of a periradicular lesion. After 1 year, the tooth was asymptomatic, and radiographic examinations confirmed no signs of periradicular pathology. Even for managing severe IRR cases, the internal approach can be a successful and minimally invasive treatment if providing an accurate procedure of treatment, the materials have good properties, and suitable equipment, such as bio-ceramic materials and a dental operating microscope, are available.