Fig. 1

Pre-operative IOPA of mandibular right  second molar showing distal caries approaching to pulp( which is partially calcified) ,also showing an internal resorption & periodical lesion confirms an irreversible pulpitis suggesting a root canal treatment for the same.

Fig. 2

Preoperative visualizzation

Fig. 3

Distal canal is found easily 

Fig. 4

Mesial canal was a bit difficult to locate because of calcification of chamber .But after an hour of handwork finally got the mesial canal.

Fig. 5

In this picture the orifices of mesial & distal canals are clearly seen  after cleaning & shaping till 30 4%.

Fig. 6

This picture is showing internal resorption on distal portion of tooth 

Fig. 7

This picture is showing internal resorption & prepared canal orifices in the same shot 

Fig. 8

Master cone IOPA 

Fig. 9

Obturation was done before sealing the resorption area just to prevent blocking of canals by MTA.

Video of the procedure.

Fig. 10

Post-op IOPA showing gutta percha in the canals ,MTA putty in resorption area & Direct composite build-up of distal caries followed by occlusal build up with the same .

Fig. 11

Comparison of Pre-op & Post-op IOPA

Fig. 12

Healing is evident in IOPA

After 1 month of recall of the patient

Conclusions

Early diagnosis, removal of the cause, proper treatment of the resorbed root is mandatory for the successful outcome .It is easy to control the process of internal root resorption via serving the blood supply top the resorbed tissue with conventional root canal therapy. Regular recalls are important to see the prognosis and healing of the tooth. 

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