External invasive resorption in a three-rooted lower first molar*

Clinical management of external cervical resorption: A systematic review

This review investigated whether any therapeutic options influenced the outcome of treatment for teeth with external cervical resorption. Out of 870 articles identified by an electronic search, 60 clinical case reports and six case series were included. No randomised clinical trials were found. Risk of bias was assessed using Joanna Briggs Institute's tools. External surgical intervention was the preferred method of accessing the lesions. Removal of resorptive tissue was most often achieved mechanically. Bioactive endodontic cements were the preferred materials for restoring teeth. The outcome measures were based on clinical and radiographic parameters. Of the cases included in the review, no specific treatment approach had a superior outcome in relation to Heithersay's classification. Furthermore, due to the absence of randomised clinical trials, and the low level of evidence associated with case reports/case series, it was not possible to define the optimum clinical treatment for external cervical resorption.

Clinical and scanning electron microscopic features of invasive cervical resorption in a maxillary molar

This case report presents clinical and morphological features of severe invasive cervical resorption (ICR) involving a maxillary first molar. Surface morphology of the ICR defect that extended into enamel was studied using a scanning electron microscope. The topography and morphology of resorbed enamel and pulpal surfaces are described. The pulpal space was characterized by proliferation of fibrovascular tissue invaded by a number of > or = 15-microm-large dentinoclastlike cells. The vertical orientation and hexagonal geometric outlines of enamel rods indicated that the resorptive defect had extended into the outer surface of enamel. Preferential odontoclastic dissolution of interprismatic enamel was noted. Deposits of a cementumlike substance were noticed on enamel surfaces, indicating that resorptive process was coupled with repair. Complete destruction of dentin was associated with no response by the tooth to cold stimulus, supporting the hydrodynamic theory of dentinal sensitivity. The results of this study indicate that in addition to predentin and cementum, the outer surface enamel may be resistant to the resorptive process as well.

Invasive cervical resorption: clinical and radiological diagnosis and treatment of 3 cases

Invasive cervical resorption is a relatively uncommon form of external root resorption. Etiologic factors include trauma, orthodontic treatment, intracoronal bleaching, and inflammation, but invasive cervical resorption is often idiopathic. There may be no external signs of this disorder, and the resorptive lesion is often detected by routine radiographic examination. This article describes the clinical and radiological diagnoses and treatment modalities of invasive cervical resorption in 3 patients. Two of the 3 cases were incidental radiographic findings and the teeth concerned were symptom free. One case was symptomatic due to periodontal infection. Computed tomography (CT) evaluation was performed in the 2 symptom-free patients. Thus, exact size and localization of the resorptive lesions were obtained. In 2 cases, root canal treatment was performed, and in the other case the resorptive defect was sealed with mineral trioxide aggregate.