Comprehensive Approach of a Traumatized and Discolored Anterior Tooth in Geriatric

The prevalence of dental trauma, particularly in permanent maxillary anterior teeth, is high and can significantly impact a patient's quality of life. Furthermore, the growing desire of elderly patients to maintain their teeth has led to an increased need for the performance of complex dental treatments. Traumatic injuries often lead to root resorption, pulp necrosis, as well as wide root canals and open apices due to disruption of tooth development. Therefore, precise strategies are required for working length determination, cleaning, and shaping, along with obturation. A 64-year-old female patient came with a chief complaint of a gradually darkening front upper tooth. The patient has a history of traumatic injury where she fell and hit her upper left central incisor. The tooth is clinically darkened, and radiographic examination revealed a periapical lesion, wide root canal, and slightly convergent apex as Stage IV Cvek classification as well as external root resorption. Endodontic treatment was done on Tooth 21 using a hybrid technique with a combination of brushing and balanced-force motion in the cleaning and shaping procedure. The treatment was completed with warm vertical compaction obturation and followed by internal and external bleaching as well as direct restoration. Endodontic treatment utilizing a hybrid cleaning and shaping technique, combined with bioceramic sealer and warm vertical compaction obturation, is effective in posttraumatized elderly teeth resulting in the healing of periapical lesions. Internal bleaching successfully addressed the coronal discoloration followed by direct composite restoration achieving a favorable aesthetic outcome.