Restor Dent Endod.  2012 Nov;37(4):228-231.

Invasive cervical resorption: treatment challenges

• Kim Y
• Lee CY
• Kim E
• Roh BD

Abstract

Invasive cervical resorption is a relatively uncommon form of external root resorption. It is characterized by invasion of cervical region of the root by fibrovascular tissue derived from the periodontal ligament. This case presents an invasive cervical resorption occurring in maxillary lateral incisor, following damage in cervical cementum from avulsion and intracoronal bleaching procedure. Flap reflection, debridement and restoration with glass ionomer cement were performed in an attempt to repair the defect. But after 2 mon, more resorption extended apically. Considering root stability and recurrence potential, we decided to extract the tooth. Invasive cervical resorption in advanced stages may present great challenges for clinicians. Therefore, prevention and early detection must be stressed when dealing with patients presenting history of potential predisposing factors.

Keyword

Dental trauma; External cervical resorption; Intracoronal bleaching; Invasive cervical resorption; Root resorption

MeSH Terms

Acrylic Resins
Debridement
Dental Cementum
Glass Ionomer Cements
Humans
Incisor
Periodontal Ligament
Recurrence
Root Resorption
Silicon Dioxide
Tooth
Acrylic Resins
Glass Ionomer Cements
Silicon Dioxide

Figure

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  Figure 1 Serial periapical radiographs. (a) Initial visit, after replantation; (b) After root canal treatment; (c) 12 months follow-up; (d) 15 months follow-up. Walking bleaching performed; (e) 30 months follow-up. ICR developed on distal surface of #12; (f) After surgical repair; (g) 1 month after the surgery; (h) 2 months after the surgery; (i) After the second surgery. Afterwards the tooth was extracted.

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  Figure 2 Microscopic view during surgical repair. Arrowheads indicate penetration points. Note the fibro-osseous tissue resembling dentin on the surface. (a) ×6; (b) ×16 magnification.

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  Figure 3 (a) Recurred sinus tract 2 months after the surgery; (b) Periapical radiograph with gutta-percha tracing reveals the origin; (c) After opening the flap once more, advanced resorption below the glass ionomer filling was clearly seen (Arrowhead).

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  Figure 4 (a) Methylene blue staing after extraction of the tooth, mesial and distal side; (b) ×20 magnification.

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