Endodontic Retreatment Using Rotary System and Aesthetic Rehabilitation of a Deciduous Central Maxillary Incisor in a...

Early childhood caries (ECC) affects the primary dentition of preschool children and can result in the need for pulp treatment. Endodontic retreatment in deciduous teeth is indicated when initial treatment fails, representing a conservative alternative to extraction.

This case describes pulp retreatment using a rotary system and complete aesthetic rehabilitation of the anterosuperior sector in a pediatric patient.

A 5-year-old systemically healthy male patient attended the clinic with ECC affecting the maxillary central and lateral incisors. Clinical examination revealed a temporary dentition with bilateral Class I molar relationship. The left maxillary central incisor presented a previous deficient endodontic obturation with material extending only one-third of the root length. The treatment plan included pulp retreatment of Tooth 61, fiberglass postplacement, and celluloid crowns on maxillary incisors, in addition to comprehensive oral cavity rehabilitation. Canal debonding was performed with K-files, removing zinc oxide eugenol. Reinstrumentation was performed with Hedstrom File #30 and the U1 file rotary system (0.40 mm, torque 2.5 N·m, and 400 RPM), with a working length of 11.5 mm. An irrigation protocol was performed using physiological saline, as well as 2.5% and 5% sodium hypochlorite. Obturation was performed with Metapex. Subsequently, a fiberglass post cemented with RelyX dual and celluloid crown with Filtek Supreme resin were placed. One-year follow-up demonstrated an asymptomatic tooth, remaining in the mouth in favorable conditions with successful aesthetic and functional restoration. The mother and patient expressed high satisfaction with the outcome.

In this pediatric case, endodontic retreatment of a deciduous maxillary central incisor using a rotary system, combined with fiberglass post placement and celluloid crown rehabilitation, resulted in favorable clinical and radiographic outcomes at 12-month follow-up. Within the limitations of a single-case report, these findings suggest that retreatment may be considered a viable conservative alternative to extraction in carefully selected clinical scenarios.