This case report describes the endodontic treatment of an idiopathic perforated internal root resorption. A 24-year-old male Malay patient presented with internal root resorption of two of his anterior teeth. The medical history was non-contributory and he had no history of traumatic injury or orthodontic treatment. Cone-beam computed tomography (CBCT) determined the nature, location and severity of the resorptive lesion. Non-surgical root canal treatment of tooth #22 and combined non-surgical and surgical approach for tooth #11 were carried out using mineral trioxide aggregate (MTA) as the filling material. The clinical and radiographic examination three years after completion of treatment revealed evidences of periapical healing. The appropriate diagnosis and the treatment of internal root resorption allowed good healing of these lesions and maintained the tooth in function for as long as possible.
Iatrogenic perforation is caused by the degradation of the dentin root floor or wall and the overlying cementum. This condition frequently arises from improper post-space preparation, root canal negotiation and preparation, and the use of misaligned burs or mechanical instruments during endodontic access. Proper management is essential; otherwise, it could lead to the need for tooth extraction. Management of iatrogenic perforation can be challenging. In this case report, a strip perforation on an upper anterior tooth was addressed for tooth rehabilitation using tricalcium silicate-based cement and a flexible glass fiber post. This approach aims to restore the tooth's function, structural integrity, and aesthetics while minimizing complications.