Non-surgical management of post-traumatic internal and external inflammatory root resorption in an immature maxillary central incisor: 4-year follow-up.

Divergent pulpal responses following dental trauma may manifest as inflammatory resorption in one tooth and pulp canal obliteration (PCO) in other affected teeth. When such changes occur in an immature tooth with an open apex, diagnosis and treatment planning become particularly challenging. This case report describes a traumatised maxillary right central incisor in a young male patient with non-perforating internal root resorption (RR), external inflammatory RR and pulp necrosis, while the maxillary right lateral and left central incisors exhibited PCO. Cone-beam CT allowed precise definition of lesion extent and supported a conservative treatment strategy comprising chemomechanical disinfection with calcium hydroxide, placement of a mineral trioxide aggregate apical barrier and thermoplastic obturation. At the 48-month follow-up, the tooth was asymptomatic and functional, with imaging evidence of periapical healing and arrest of resorption. The biologically based conservative approach resulted in sustained function, satisfactory aesthetics and overall patient satisfaction.