Surgical Treatment of an Immature Short-Rooted Traumatized Incisor with an Extensive Apical Lesion Using CEM Cement

Severe traumatic injuries to immature teeth often cause damage to periodontal ligament as well as dental pulp; pulp necrosis, root resorption and subsequent apical lesion are common consequences. This article reports the surgical management of an infected immature maxillary central incisor associated with a gigantic periradicular lesion and severe root resorption. The tooth had a history of trauma and the patient suffered from purulent sinus tract and tooth mobility. After unsuccessful multi-session disinfection with calcium hydroxide, root end surgery was planned. During flap surgery and lesion enucleation, the root end was cleaned and filled with calcium-enriched mixture (CEM) cement. After one year, the radiographic examination revealed that the lesion was almost completely replaced with newly formed bone. In addition, clinical examination showed favorable outcomes; the tooth was symptom-free and in function. Due to chemical, physical and biological properties of CEM cement, this biomaterial might be considered as the root-end filling material of choice.