Comprehensive Approach of a Traumatized and Discolored Anterior Tooth in Geriatric

Area of Science:

• Endodontics
• Dental Traumatology
• Geriatric Dentistry

Background:

• Dental trauma is prevalent in permanent maxillary anterior teeth, impacting quality of life.
• Elderly patients increasingly seek to preserve teeth, necessitating complex endodontic treatments.
• Traumatic injuries can cause root resorption, pulp necrosis, and developmental anomalies like wide root canals and open apices.

Purpose of the Study:

• To describe the endodontic management of a post-traumatic maxillary anterior tooth in an elderly patient.
• To evaluate the efficacy of a hybrid cleaning and shaping technique with warm vertical compaction obturation.
• To assess the outcomes of internal bleaching and direct restoration for coronal discoloration and aesthetics.

Main Methods:

• A 64-year-old female patient with a darkened, traumatized maxillary central incisor (Tooth 21) was treated.
• Endodontic treatment involved a hybrid cleaning and shaping technique (brushing and balanced-force motion).
• Obturation was performed using warm vertical compaction with a bioceramic sealer, followed by internal/external bleaching and direct composite restoration.

Main Results:

• Radiographic examination revealed a periapical lesion, wide root canal, and Stage IV Cvek classification with external root resorption.
• Endodontic treatment led to the healing of the periapical lesion.
• Internal bleaching resolved coronal discoloration, and direct restoration achieved a favorable aesthetic outcome.

Conclusions:

• A hybrid cleaning and shaping technique combined with bioceramic sealer and warm vertical compaction is effective for post-traumatic elderly teeth.
• Endodontic treatment successfully healed periapical lesions in this case.
• Internal bleaching and direct restoration provided a successful aesthetic solution for coronal discoloration.