Management Of Perforating External Cervical Root Resorption

Abstract

Introduction: External cervical resorption (ECR) is the loss of dental hard tissue as a result of odontoclastic action; it usually begins on the cervical region of the root surface of the teeth. The etiology and predisposing factors are not very clear. The aim of this case report is to show the management of maxillary right canine diagnosed with ECR. Case Report: A 54-year old female patient was referred to our clinic with the history of dentin hypersensitivity in maxillary right anterior area. Radiographic examination revealed a radiolucent lesion located on the cervical third of maxillary right canine. The tooth was clinically asymptomatic. The patient did not report any traumatic history. CBCT scans revealed the extent of the resorption cavity and confirmed the diagnosis of the lesion. Due to perforation of the resorption into the root canal space, the access cavity was opened and temporarily occluded with a gutta-percha point. Then the surgical repair of the resorptive defect was carried out without blocking the root canal with filling material. A mucoperiosteal flap was elevated to clean the granulamatous tissue. The lesion was apparent after complete degranulation of soft tissue. It was repaired with MTA-Angelus (Angelus, Londrina, PR, Brazil) , a glass ionomer and a composite resin. The flap was replaced and sutured. Once the ECR cavity was restored, then endodontic treatment was completed in the same appointment. The root canal was obturated with gutta percha and root canal sealer by cold lateral condensation. . Conclusion: In the 9-month follow-up examination, the tooth including ECR defect was completely asymptomatic and functional. Early detection is necessary for successful management and outcome of ECR. CBCT should be considered for the assessment and/or management of ECR.