GD570 - Invasive cervical resorption: clinical management of necrotic pulp-GD570 Article

GD570 Article

Pdf Summary

Invasive cervical resorption (ICR) is an uncommon, aggressive form of external root resorption that can be mistaken for internal resorption or caries. Its causes are uncertain and likely multifactorial; proposed risk factors include trauma, orthodontic treatment, and bruxism. Early diagnosis is important because treatment success generally declines as lesions advance. Cone beam computed tomography (CBCT) helps identify a lesion’s location, extent, and relationship to the root canal.<br /><br />This case report describes a 42-year-old man with class 3Ap ICR in the maxillary left canine and chronic apical periodontitis. He had no symptoms, but the tooth had previously been recommended for extraction. CBCT clarified the diagnosis and showed that the resorption extended into the middle root third, involved a broad area, and communicated with the pulp.<br /><br />Treatment combined endodontic therapy, periodontal surgery, and restoration. After removal of resorptive and granulation tissue, the canal was treated and obturated, with mineral trioxide aggregate used to fill the affected portion. Surgically, the lesion was curetted and refined, then sealed with a bioactive resin containing surface-treated prereacted glass ionomer (S-PRG) filler. The authors selected the resin for its adaptability and smooth finish in the cervical area.<br /><br />At six months, clinical examination and CBCT showed no symptoms, mobility, periodontal pocket, or radiographic evidence of recurrence. The authors emphasize that advanced ICR requires coordinated endodontic, surgical, and restorative care, and that patients should be informed of possible complications, including tooth loss. Although the result was favorable, evidence on ICR treatment remains limited, and longer follow-up is needed.

Keywords

invasive cervical resorption

ICR

external root resorption

cone beam computed tomography

CBCT

endodontic therapy

periodontal surgery

maxillary canine

mineral trioxide aggregate

bioactive resin