Fig. 1

Preop images of the clinical case. The lateral incisor is extremely rotated and inclined

Fig. 2

Preop xray before segmental osteotomy

Fig. 3

Post op image and X-rays. 

From the X-ray it was immediately noticed that the root was compromised and, at first, the vitality test was almost completely negative

Fig. 4

CBCT

A CBCT was requested for evaluating the level of the damage and the root resulted half cut almost at the apical level. Considering the uncertain situation, it has been decided to wait and do not make any root canal treatment, hoping that vitality of the tooth after 3 months would be positive.

Fig. 5

3-6-12 months follow up

After 3 months vitality was better and remained stable after 6 and 12 months.

No signs of resorption appeared on the root line

Fig. 6

18 months follow up

Vitality was stable and also no tooth discoloration occurred. The interesting thing was also that no signs of resorption appeared 

Conclusions

Sometimes in Endodontics the best strategy is wait instead of action. This case would not have been  easy to treat in a predictable way.

Bibliography

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Andreasen, J.O. (1980) Analysis of Pathogenesis and Topography of Replacement Resorption (Ankylosis) after Replantation of Mature Permanent Incisors in Monkeys. Swedish Dental Journal, 4, 231-240.

Bishara, S.E. (1992) Impacted Maxillary Canines: A Review. American Journal of Orthodontics and Dentofacial Orthopedics, 101, 159-171.  http://dx.doi.org/10.1016/0889-5406(92)70008-X

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