Surgical Endodontic Management of External Root Resorption and Apexification Using New Calcium Silicate-Based Materials

External resorption and open apex are pathological conditions which can occur due to chronic inflammation after a dental trauma. In order to stop the pathological conditions, surgical correction and apexification is performed. New calcium silicate-based materials are used as new variety of Mineral Trioxide Aggregate (MTA) to increase the setting time and easier manipulation. This report presents external root resorption arrest and formation of an apical barrier by surgical perforation repair due to external resorption and apexification of post-traumatic necrosis tooth. A 22-year-old male patient was presented to Conservative Dentistry Department based on referral of Prosthodontics for upper left lateral incisor examination. The patient had a history of trauma 10 years ago and no symptoms had been noted since then. Percussion test was positive. Palpation, thermal and electrical test were negative. Periapical radiograph and Cone Beam Computed Tomography (CBCT) examination revealed radiolucency lesions in central and lateral middle third of root with blunt apex and periapical lesion. Surgical correction of external resorption and apexification was done using new calcium silicate-based materials. Tooth was restored using resin composite with prefabricated fiber post as intracanal reinforcement. Radiographs of treatment after 1 month and 6 months showed well-covered resorption area, less periapical lesions and good result for apical barrier formation. The new calcium silicate-based materials can be used in perforation repair due to external resorption and apexification treatments.