Abstract

Background: Displaced anterior teeth may be associated with periapical lesions and form an ortho-endo problem that requires special attention and careful planning. This case report documented the use of an intracanal medicament to stimulate the healing of a large periapical lesion and treat severely displaced incisors. Methods: A 13-year-old patient was presented with a 14x26 mm periapical radiolucency related to displaced incisors. After chemo-mechanical preparation, calcium hydroxide medicament was placed in the canals and changed every 2 weeks for 3 months. The canal was then freshly cleaned and filled with gutta‐percha and sealer. The coronal preparation was sealed with glass ionomer filling. Results: At the 24-month follow-up, the teeth were asymptomatic. The radiographs showed correction of the incisor displacement after bone regeneration, and a significant reduction in the lesion size. Conclusion: Conventional endodontics with an intracanal medicament can correct an ortho-endo problem in incisors with a large periapical lesion. Clinical significance: Dentists should not initiate orthodontic intervention for an endoortho problem until the periapical lesion has completely healed. 

Keywords

calcium hydroxide, intracanal medicament, periapical lesion, ortho-endo problem, severely displaced incisors