Management of external cervical resorption with internal approach: 18 months of follow-up

Abstract

Introduction: External cervical resorption (ECR) in advance stages may have a probable pulp involvement. In some of these cases, the accessibility of the resorptive process can be performed by an intraradicular approach. Aim: To report the management of an ECR, classified as Class 2cp according to Patel classification, with an internal approach. Case report: A 22-year-old male patient presented a complaint of dentin hypersensitivity related to left maxillary lateral incisor and reported a history of previous dental trauma. Based on the clinical, radiographic and tomographic findings, the left maxillary lateral incisor was diagnosed as symptomatic irreversible pulpitis with ECR class 2cp of Patel classification. The patient was scheduled for endodontic treatment, with an internal approach, and repair of the resorbed area. Intracanal dressing of calcium hydroxide paste was used in the root canal and resorption gaps. The root canal filling was performed in two steps: obturation of the apical and middle third with gutta-percha by lateral condensation technique and obturation of the cervical third and filling the resorbed area with MTA. After 18 months signs and symptoms compatible with success were observed, and the tomographic and radiographic images suggested a successful endodontic treatment and evolutionary process of repair of bone and mineralized dental tissues. Conclusion: Patel class 2cp ECR treatment through an internal approach, including conventional endodontic treatment and recovery of the reabsorbed area with calcium hydroxide and MTA is a viable treatment option, but may cause tooth discoloration.