Endodontic-surgical-orthodontic managementof maxillary central incisorwith root dilaceration andlarge apical periodontitisusing leukocyte andplatelet-rich fibrin

Teeth with root dilaceration represents a challenge in clinical practice when an intervention is needed, especially in cases requiring a multidisciplinary approach to resolve the issue. Aim: This report describes the root dilaceration of a maxillary central incisor with severe apical periodontitis,...

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Detalles Bibliográficos
Autores: Alves, Regis Augusto Aleixo, Morais, André Luiz Gomide, Sestari, Larissa Emanuelle, Angelino, Guilherme Lopes, Estrela, Carlos
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:Brasil
Institución:Universidade Estadual de Campinas (UNICAMP)
Repositorio:Brazilian journal of oral sciences (Online)
Idioma:inglés
OAI Identifier:oai:ojs.periodicos.sbu.unicamp.br:article/8675030
Acceso en línea:https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8675030
Access Level:acceso abierto
Palabra clave:Periapical periodontitis
Apicoectomy
Cone-beam computed tomography
Endodontics
Orthodontics
Descripción
Sumario:Teeth with root dilaceration represents a challenge in clinical practice when an intervention is needed, especially in cases requiring a multidisciplinary approach to resolve the issue. Aim: This report describes the root dilaceration of a maxillary central incisor with severe apical periodontitis, involving a 4-year follow-up of endodontic surgical-orthodontic management using leukocyte and platelet-rich fibrin (L-PRF). Methods: The planning process included treating the root canal and the central maxillary incisor affected by distoangular root dilaceration, by using orthodontic repositioning of the neighboring tooth, and an endodontic and periapical surgical approach. The operative procedure used cone-beam computed tomography (CBCT) scans of the left maxillary central incisor, taken prior to orthodontic tooth movement maxillary lateral incisor. Orthodontic treatment was performed after the endodontic treatment, and followed by surgical management with periapical lesion curettage, apicoectomy, retro-preparation, retro-filling and grafting with L-PRF, resulting in a successful conclusion. Conclusion: The four-year clinical follow-up showed complete alignment of the maxillary lateral incisor and signs of periapical healing based on CBCT images.