Endo-esthetic Management of Permanent Maxillary Lateral Incisor with Severe Root Dilaceration in a 12-year-old Child

Functional, esthetic and endodontic restoration of a pulpally involved permanent incisor with root dilaceration often presents a daunting clinical challenge. The outcome of conventional treatment modalities like surgical removal of the tooth followed by orthodontic closure of the space is time consuming and esthetically compromising. Even the prosthetic and implantalogical rehabilitation after extraction is not possible until the patient reaches certain age; while the compliance is a problem with the use of removable partial denture in young children. Autoalloplastic anterior tooth transplantation can lead to physical and psychological trauma in a young individual. Thus endo-esthetic management of such teeth helps in maintaining both morphology and esthetics in a growing child until the permanent long lasting prosthetic solution is sought after the complete development of the dentition and jaws. This treatment option for a pulpally involved permanent incisor with root dilaceration involves completing the endodontic treatment in a partially calcified and aberrantly located root canal followed by the use of light transmitting fiber post and core build up using composite resin.