Citation Information :
Halboub E, Chourasia HR, Roges RA. Nonsurgical Management and 2-year Follow-up by means of Cone Beam Computed Tomography of an Invasive Cervical Resorption in a Molar. J Contemp Dent Pract 2018; 19 (9):1152-1156.
Background: Invasive cervical resorption (ICR) is a relatively uncommon form of external tooth resorption, characterized by an invasive nature. It is usually painless and detection of lesions is often made incidentally. Three-dimensional imaging techniques, such as cone beam computed tomography (CBCT), are useful in the diagnosis and management of ICR as the true extent of the defect cannot always be estimated using conventional radiographs.
Aim: The aim of this article is to report on the successful treatment of ICR in mandibular first molar by nonsurgical approach and follow-up by means of CBCT.
Case report: An 18-year-old patient was referred with a complaint of unusual radiolucency in the mesial cervical area of tooth #19 with unknown etiology. Cone beam computed tomography was performed to assess the extent of the lesion in three spatial levels and diagnosis of Heithersay class III ICR was made. This case presented with ICR (Heithersay class III) on tooth #19. Nonsurgical root canal treatment and removal of the lesion from the coronal access was performed; the resorptive defect was filled with dual-cure, self-adhesive, resin-modified glass ionomer cement (RMGIC); 6-month follow-up X-ray film showed no changes at the lesion site and tooth was asymptomatic; 1-year follow-up X-ray film showed slight mesial bone loss and a probing depth of 3 mm; finally, 2-year follow-up CBCT images showed no recurrence and no further bone destruction at the lesion site.
Conclusion: The intraoral radiographs revealed the resorptive changes in two dimensions; therefore, the actual extent and location of the lesions are not fully understood. On the contrary, CBCT is a very useful tool to achieve a proper diagnosis; it detects the extent of the defect more accurately and hence, improves the treatment outcomes of ICR.
Clinical significance: The ICR is usually seen as a late complication to traumatic injuries of the teeth; it is essential, therefore, that the patients who were exposed to situations that can damage the integrity of periodontal tissue need to have careful periodic recalls and X-ray examinations.
Heithersay GS. Clinical, radiologic and histopathologic features of invasive cervical resorption. Quintessence Int 1999 Jan;30(1):27-37.
Heithersay GS. Invasive cervical resorption: an analysis of potential predisposing factors. Quintessence Int 1999 Feb;30(2):83-95.
Mavridou AM, Pyka G, Kerckhofs G, Wevers M, Bergmans L, Gunst V, Huybrechts B, Schepers E, Hauben E, Lambrechts P. A novel multimodular methodology to investigate external cervical tooth resorption. Int Endod J 2016 Mar;49(3):287-300.
Tronstad L. Root resorption: etiology, terminology and clinical manifestations. Endod Dent Traumatol 1988 Dec;4(6):241-252.
Patel S, Dawood A. The use of cone beam computed tomography in the management of external cervical resorption lesions. Int Endod J 2007 Sep;40(9):730-737.
Heithersay GS. Invasive cervical resorption. Endod Topics 2004;7(1):73-92.
Heithersay GS. Invasive cervical resorption following trauma. Aust Endod J 1999 Aug;25(2):79-85.
AAE and AAOMR Joint Position Statement: use of cone beam computed tomography in endodontics 2015 update. J Endod 2015 Sep;41(9):1393-1396.
Kamburoglu K, Barenboim SF, Arýtürk T, Kaffe I. Quantitative measurements obtained by micro-computed tomography and confocal laser scanning microscopy. Dentomaxillofac Radiol 2008 Oct;37(7):385-391.
Estevez R, Aranguren J, Escorial A, de Gregorio C, De La Torre F, Vera J, Cisneros R. Invasive cervical resorption Class III in a maxillary central incisor: diagnosis and followup by means of cone-beam computed tomography. J Endod 2010 Dec;36(12):2012-2014.
Subramanyappa SK, Parthasarathy B, Manjegowda PG, Rajeev S. Management of perforating invasive cervical resorption: two case reports. J Indian Acad Oral Med Radiol 2012 Dec;24(4):346-349.
Tavares WL, Lopes RC, Oliveira RR, Souza RG, Henriques LC, Ribeiro-Sobrinho AP. Surgical management of invasive cervical resorption using resin-modified glass ionomer cement. Gen Dent 2013 Nov-Dec;61(7):e16-e18.
Yilmaz HG, Kalender A, Cengiz E. Use of mineral trioxide aggregate in the treatment of invasive cervical resorption: a case report. J Endod 2010 Jan;36(1):160-163.
Ikhar A, Thakur N, Patel A, Bhede R, Patil P, Gupta S. Management of external invasive cervical resorption tooth with mineral trioxide aggregate: a case report. Case Rep Med 2013;2013:139801.
Utneja S, Nawal RR, Talwar S, Verma M. Current perspectives of bio-ceramic technology in endodontics: calcium enriched mixture cement—review of its composition, properties and applications. Restor Dent Endod 2015 Feb;40(1):1-13.
Baranwal AK. Management of external invasive cervical resorption of tooth with biodentine: a case report. J Conserv Dent 2016 May-Jun;19(3):296-299.
Fuss Z, Tsesis I, Lin S. Root resorption-diagnosis, classification and treatment chooses based on stimulation factors. Dent Traumatol 2003 Aug;19(4):175-182.
Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M. Tissue dissolution by sodium hypochlorite: effect of concentration, temperature, agitation, and surfactant. J Endod 2010 Sep;36(9):1558-1562.
Simon J, de Rijk WG. Dental cements. Inside Dentistry 2006;2(2):42-47.
Estafan D, Pines MS, Erakin C, Fuerst PF. Microleakage of Class V restorations using two different compomer systems: an in vitro study. J Clin Dent 1999;10(4):124-126.
Lee SJ, Monset M, Torabinejad M. Sealing ability of mineral trioxide aggregate for repair of lateral root perforations. J Endod 1993 Nov;19(11):541-544.
Koh ET, McDonald F, Pitt Ford TR, Torabinejad M. Cellular response to mineral trioxide aggregate. J Endod 1998 Aug;24(8):543-547.
Schwartz RS, Robbin JW, Rindler E. Management of invasive cervical resorption: observations from three private practices and a report of three cases. J Endod 2010 Oct;36(10): 1721-1730.
