Management of maxillary molar undergoing buccal bone resorption due to orthodontic banding

Abstract

The consequences of injudicious use of orthodontic braces may vary from mild periodontal problems to severe loss of the attached periodontal tissues. In this case the patient had undergone orthodontic treatment. Though her appearance improved after the orthodontic treatment, but tooth # 16 which was banded and used for anchorage showed complete crestal and apical bone dehiscence in the buccal region. The patient came with the complaint of discomfort and inability to chew on the right side of maxilla. On intraoral examination, unusual calculus was seen deposited on the gums. X-ray showed resorption of buccal roots of tooth # 16. The patient was treated endodontically for the same tooth as it was grossly carious with exposed pulp chamber but incomplete root canal treatment. The buccal canals showing resorption were disinfected and overfilled to an extent that GP points became visible in the buccal sulcus. Raising the flap, the affected roots were cleaned and planed and the extruded GP cut and the roots resected and sealed with glass ionomer cement to encourage reattachment of periodontal apparatus. After 9-month of recall, patient is performing well with improved periodontal attachment and firmly standing tooth in the socket.