INTRODUCTION: This case report presents the diagnosis and management of extensive internal root resorption (IRR) in a 17-year-old male patient, with a 9-year-old history of trauma. METHOD: The affected tooth 21 was associated with vertical root fracture (VRF) and incomplete apex closure with a substantial loss of tooth structure, including dentin and cementum. Encouraged by a healthy periodontal condition, the choice was made to use mineral trioxide aggregate (MTA) to reconstruct and reinforce the resorptive defect and the fractured segment. A composite veneer was placed to enhance the aesthetics. RESULT: A follow-up of the patient after 2 years revealed healing with a resolution of the lesion. CONCLUSION: This case report highlights the use of MTA as a lone-standing filling material for the treatment of IRR with VRF in a non-vital immature tooth.
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