Management of Discolored Endodontically Treated Maxillary Central Incisors With Nonsurgical Retreatment and Internal...

Tooth discoloration in endodontically treated anterior teeth represents a clinically significant problem, particularly in cases with high esthetic expectations. When pain, percussion sensitivity, or radiographic findings accompany such teeth, the existing endodontic status should be reassessed before esthetic treatment. This case report presents the clinical management of a 28-year-old patient who presented with pain, percussion sensitivity, and marked coronal discoloration in previously endodontically treated maxillary central incisors, teeth #11 and #21. After removal of the existing root canal filling materials, the root canals were reshaped, an irrigation protocol was performed, and calcium hydroxide was placed as an intracanal medicament. After resolution of the symptoms, the root canals were obturated with a bioceramic-based root canal sealer and gutta-percha. Following the placement of a cervical barrier, internal bleaching was performed. At the end of treatment, the patient's symptoms had resolved, and a marked improvement in anterior esthetics was observed. This case demonstrates that, in symptomatic and discolored endodontically treated anterior teeth, initial infection control followed by conservative esthetic rehabilitation with internal bleaching may represent a clinically appropriate approach.