Large Resorptive Lesions: Endodontist’s Dilemma to Treat or Extract?
Abstract
Case Report: 38-year-old male complained of discolored upper front teeth. Cone Beam CT scan confirmed the clinical diagnosis of invasive cervical resorption (ICR) teeth 11, 21. The treatment plan was a stepwise process, involving extraction of 21, immediate denture placement, followed by restoration of resorption defect tooth 11 and prosthetic replacement tooth 21. The patient was asymptomatic clinically and radiographically at 3-, 6- and 18-months intervals.
Discussion: Due to enigmatic etiology, ICR is often misdiagnosed and mistreated. Thus, proper diagnosis and treatment planning is vital for a successful outcome. This report helps in establishing standardized protocol in diagnosis and treatment of ICR.
References
Kandalgaonkar SD, Gharat LA, Tupsakhare SD, Gabhane MH. Invasive cervical resorption: a review. JIOH. 2013;5(6):124.
Tronstad L. Root resorption--etiology, terminology and clinical manifestations. Endod Dent Traumatol. 1988; 4:241–52
Petel R, Fuks A. Pink Spot–Literature Review and Case Report. Journal of Clinical Pediatric Dentistry. 2016;40(5):353-5.}
Brown CE, Steffel CL, Morrison SW. A case indicative of rapid, destructive internal resorption. Journal of Endodontics. 1987 Oct 1;13(10):516-8.
HEITHERSAY GS. Clinical endodontic and sur-gical management of tooth and associated bone resorption. International Endodontic Journal. 1985;18(2):72-92.
Jeng PY, Lin LD, Chang SH, Lee YL, Wang CY, Jeng JH, Tsai YL. Invasive cervical resorption—distribution, potential predisposing factors, and clinical characteristics. Journal of endodontics. 2020 Apr 1;46(4):475-82.
Suhr Villefrance J, Kirkevang LL, Wenzel A, Væth M, Matzen LH. Impact of cone beam CT on diagnosis of external cervical resorption: the severity of resorption assessed in periapical radiographs and cone beam CT. A prospective clinical study. Dentomaxillofacial Radiology. 2022 Feb 1;51(2):20210279.
Matny LE, Ruparel NB, Levin MD, Noujeim M, Diogenes A. A volumetric assessment of external cervical resorption cases and its correlation to classification, treatment planning, and expected prognosis. Journal of endodontics. 2020;46(8):1052-8.
Bardini G, Orrù C, Ideo F, Nagendrababu V, Dummer P, Cotti E. Clinical management of external cervical resorption: A systematic review. Aust Endod J. 2023;49(3):769-787. doi: 10.1111/aej.12794. Epub 2023 Sep 13. PMID: 37702252.
Rotondi O, Waldon P, Kim SG. The disease process, diagnosis and treatment of invasive cervical resorption: a review. Dentistry journal. 2020;8(3):64.
Elemam RF, Pretty I. Comparison of the success rate of endodontic treatment and implant treatment. International Scholarly Research Notices. 2011;2011.
Uthappa R, Mod D, Kharod P, Pavitra S, Ganiger K, Kharod H. Comparative evaluation of the metal post and fiber post in the restoration of the endodontically treated teeth. Journal of Dental Research and Review. 2015;2(2):73.
Patel S, Dawood A, Wilson R, Horner K, Mannocci F. The detection and management of root resorption lesions using intraoral radiography and cone beam computed tomography–an in vivo investigation. International endodontic journal. 2009;42(9):831-8.
Fernandes M, de Ataide I, Wagle R. Tooth resorption part II - external resorption: Case series. J Conserv Dent. 2013;16:180-5
Kothari HJ, Kumar R. Endodontic management of a mandibular second premolar with per-forating internal resorption by using MTA and cone beam computed tomography as a diagnostic aid. J Conserv Dent. 2013;16:380-4
Asgary S, Dianat O. Invasive Cervical Root Resorption: A Comprehensive Review on Patho-genesis, Diagnosis, and Treatment. Iran Endod J. 2024;19(1):2-12. https://doi.org/10.22037/iej.v19i1.44246. PMID: 38223835; PMCID: PMC 10787181.
Tuna EB, Yaman D, Yamamato S. What is the best root surface treatment for avulsed teeth? The open dentistry journal. 2014; 8:175.
Sharma R, Swami A, Smitha B V. Surgical root repair of extensive invasive cervical resorption defects involving the cementoenamel junction: Two case reports. Endodontology. 2018; 30:171-6. https://doi.org/10.1007/s10266-025-01148-8
Silveira LF, Silveira CF, Martos J, Piovesan EM, César Neto JB. Clinical technique for invasive cervical root resorption. J Conserv Dent. 2011;14(4):440-4. https://doi.org/10.4103/0972-0707.87225. PMID: 22144822; PMCID: PMC3227300.
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