Non-surgical retreatment of a central incisor following dental trauma

A 20-year-old woman was referred suffering from occasional, spontaneous toothache around the maxillary right central incisor (UR1). This radiated to an area underneath the nose and varied in intensity, but could be sufficiently bad to disrupt normal activity, such as driving a car. She was unable to bite on the tooth without discomfort. When she was nine years old, she had tripped and fallen onto a post, traumatising the UR1 and causing an enameldentine fracture that did not expose the pulp. From the patient’s perspective everything appeared to be fine until about three years after the accident, when the UR1 started to become painful to bite on and the gum was sore. The general dental practitioner root filled the tooth and it settled down. More recently, this young lady had become very conscious of the tooth darkening and sought the opinion of a new dentist to see whether a veneer was feasible. When a periapical radiograph was exposed it showed a poor root filling and large apical radiolucency. Her medical history was uncomplicated, and apart from an allergy to penicillin, she was fit and well. This article describes the non-surgical retreatment of a central incisor that had previously suffered trauma. The immature root was managed using a biological approach with micro-endodontic techniques.