Maxillary anterior teeth with extensive root resorption treated with low-level light-activated engineered chitosan nanoparticles.

Abstract Introduction Photoactivated chitosan-based nanoparticles can eliminate bacterial biofilm, inactivate endotoxins, improve resistance to biological degradation (resorption) besides promoting bone regeneration. This case is the first documentation to highlight the successful healing of teeth with extensive inflammatory root resorption (IRR) with periapical lesions using a combined Surgical and Non-Surgical Root Canal Therapy using rose-bengal functionalized chitosan nanoparticles (CSRBnp). Methods A 17-year-old boy with extensive IRR of maxillary right canine (teeth #6), maxillary right lateral incisor (#7), maxillary right central incisor (#8) and maxillary left central incisor (#9) was treated with photoactivated CSRBnp, both intra-canal as well as topically on resorptive defects and periapical lesions. The larger external resorptive defects on the root surfaces were restored with Biodentine®. Whereas the through-and-through periapical lesions were packed with sticky bone for Guided Bone Regeneration. Results At 26 months follow-up, the clinical, 2- dimensional (intra-oral periapical radiographs) and 3-dimensional (cone beam computed tomography) images showed absence of clinical symptoms, teeth mobility, arrested IRR as well as significant osseous healing of the periradicular region. Post-operatively, the patient retraumatized thrice in relation to #7 resulting in horizontal root fracture, which showed type I pattern of root fracture healing in the follow-up. Conclusions Photoactivated chitosan-based nanoparticles can be a viable therapeutic option to hinder root resorption while enhancing healing outcomes in cases of severe IRR.