surgical treatment of an immature short-rooted traumatized incisor with an extensive apical lesion using cem cement

severe traumatic injuries to immature teeth often cause damage to periodontal ligament as well as dental pulp; pulp necrosis, root resorption and subsequent apical lesion are common consequences. this article reports the surgical management of an infected immature maxillary central incisor associated with a gigantic periradicular lesion and severe root resorption. the tooth had a history of trauma and the patient suffered from purulent sinus tract and tooth mobility. after unsuccessful multi-session disinfection with calcium hydroxide, root end surgery was planned. during flap surgery and lesion enucleation, the root end was cleaned and filled with calcium-enriched mixture (cem) cement. after one year, the radiographic examination revealed that the lesion was almost completely replaced with newly formed bone. in addition, clinical examination showed favorable outcomes; the tooth was symptom-free and in function. due to chemical, physical and biological properties of cem cement, this biomaterial might be considered as the root-end filling material of choice.