• Sumalee Songpaisan D.D.S., Grad. Dip. in Clin. Sc. (Endodontics)

One of the most common problems of patients having fixed orthodontic appliance is oral
hygiene negligence, which leads to dental caries and, in some cases, may need endodontic treatment.
If the tooth designated to be an anchorage for the tooth movement has a large periapical lesion, then
the orthodontic treatment plan may have to be altered. Also, endodontic considerations for such tooth
are to be determined in accordance with the orthodontic treatment, and it is extremely crucial to keep
the case under close supervision until complete healing is ascertained. This case report presents a 19
year-old Thai female having fixed orthodontic appliance, and failing to keep dental appointments for
one year. Finally she came back with a pain in the left mandibular first molar which had been used
as an anchorage. Clinically the tooth was found to have mobility and swelling, while a large radiolucent
area involving the furcation and periapical region was revealed by radiographic assessment.
After six months of endodontic treatment, the radiograph demonstrated an evidence of healing;
therefore, the final root canal obturation was performed and the orthodontic treatment was resumed.
The radiographic examination at one-year recall showed a substantial healing at the periapical area.
The tooth was capable of being an anchorage for the orthodontic procedure with no complication.

(CU Dent J. 2005;28:237-44)