Orthodontic Movement After Regenerative Endodontic Procedure in Mature Permanent Tooth Associated With Dens Invaginatus: A Case Report With 3-year Follow-Up

Abstract

<title>Abstract</title> Background Regenerative endodontic procedures (REPs) are innovative treatments aimed at restoring damaged dental structures. However, the effect of orthodontic movement on REP-treated teeth is not well understood and may have significant long-term consequences. This study aimed to evaluate the impact of orthodontic movement on a mature permanent tooth associated with dens invaginatus that has undergone a regenerative endodontic procedure (REP). Case presentation: This case involves a preliminary investigation into the effects of orthodontic movements on a mature REP-treated tooth. This could have the potential to enrich our collective understanding and guide treatment planning, leading to the development of clinical guidelines. This report describes the case of a 13-year-old male with a noncontributory medical history who presented with pulp necrosis and a chronic apical abscess (tooth number 2.2). Following REP according to the American Association of Endodontists' guidelines, the patient began orthodontic treatment after 9 months. Subsequent follow-ups at 9 months, 2 years, and 3 years post-REP revealed an asymptomatic state with minimal cervical discolouration and diminished cold sensitivity. Radiographic analyses revealed periapical healing, dentin wall thickening, and consistent root length. The treated tooth displayed a positive response to both REP and orthodontic treatment, yet further research is necessary to determine the long-term effects of orthodontic forces on REP-treated teeth. Conclusion Our findings suggest that orthodontic movement following REPs in mature permanent teeth is feasible and may also act as a protective factor against apical root resorption. Our experience indicates that a 9-month healing period permits successful orthodontic outcomes following REPs. Nonetheless, the predictability of outcomes and the ideal healing period before orthodontic movement is initiated remain to be established.