DISCUSSION Internal inflammatory resorption is initiated by clastic activity within chronically inflamed vital pulp tissue.[1] Trauma is considered a major etiologic factor because damage to predentin and the odontoblastic layer may expose mineralized dentin to odontoclasts.[2] In the present case, childhood trauma was considered the probable initiating factor. Diagnosis of internal resorption may be difficult because lesions are often asymptomatic. Conventional radiographs may reveal characteristic enlargement of the pulp space, but their two‑dimensional nature limits accurate assessment of lesion extent and perforation.[11] CBCT enables precise three‑dimensional evaluation and facilitates differentiation from external cervical resorption.[3] In the present case, CBCT confirmed preservation of the external root surface and absence of perforation, enabling conservative nonsurgical management. Histopathologic examination demonstrated chronic inflammatory infiltrate, multinucleated odontoclast‑like cells, and resorptive lacunae adjacent to dentinal fragments, findings consistent with internal inflammatory resorption.[1] Histopathologic correlation is infrequently reported in clinical case reports but provides valuable biological confirmation of the diagnosis and strengthens the correlation between clinical and radiographic findings. The primary objective of treatment is the elimination of inflamed pulp tissue to arrest clastic activity.[1] Chemomechanical debridement and intracanal medication are effective in halting the progression of the lesion. Similar conservative multidisciplinary management approaches for extensive internal inflammatory resorption have also been reported in the literature.[12] In the present case, obturation with bioceramic sealer provided satisfactory adaptation within the irregular canal anatomy.[13] Extensive internal resorption significantly weakens dentinal walls, especially in the cervical region where stress concentration is highest.[4] Conventional management strategies include calcium silicate‑based materials, thermoplasticized obturation techniques, fiber posts, and composite restorations.[5,7,14] Although these approaches provide adequate sealing and clinical success, reinforcement of severely weakened cervical dentin may remain challenging.[14] The present biomimetic approach utilized polyethylene fiber incorporated within fiber‑reinforced composite to provide conservative internal reinforcement without aggressive post preparation. Polyethylene fibers act as a stress‑distributing scaffold capable of limiting crack propagation within weakened dentin.[6] Fiber‑reinforced composites have also demonstrated improved biomechanical behaviour and fracture resistance in structurally compromised teeth.[5] The restorative strategy used in this case was consistent with principles of the Bio block or Bio‑Bulk concept described by Fráter et al., in which short fiber‑reinforced composite was used to reinforce roots affected by internal resorption.[8] However, unlike the Bio block technique where the canal space was extensively reinforced with fiber composite, the present case incorporated polyethylene fiber reinforcement mainly within the cervical region and canal orifice to preserve remaining dentin and enamel. Similar studies have demonstrated favourable stress distribution and reinforcement using fiber‑reinforced restorative materials in weakened teeth.[9,10] Although fiber‑reinforced restorative strategies have been investigated in endodontically treated teeth, reports describing polyethylene fiber reinforcement combined with CBCT‑guided diagnosis and histopathologic correlation in extensive internal inflammatory resorption remain limited. The present case is clinically relevant because treatment was directed not only toward elimination of the resorptive process but also toward biomechanical rehabilitation of the structurally compromised tooth. Unlike conventional restorative approaches focused primarily on obturation or defect repair, the present technique emphasized conservative internal reinforcement and preservation of weakened cervical dentin. The combined use of CBCT‑guided diagnosis, histopathologic confirmation, and biomimetic polyethylene fiber reinforcement therefhighlights the novelty and multidisciplinary relevance of the present management approach. Nevertheless, long‑term clinical studies and larger case series are required to further evaluate the durability, fracture resistance, and long‑term clinical performance of this conservative biomimetic reinforcement approach.

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