Management of seven external cervical resorptions

Abstract

Aim: External cervical resorption (ECR) assessment and its management planning are often difficult. This work proposes a standardized workflow for ECR treatment considering the 3D-classification of the lesion by Patel and assesses its clinical applicability to 7 preliminary clinical cases. Summary: ECR cases were detected from medical and dental history, clinical data and a conventional radiography; a Cone Beam Computed Tomography (CBCT) with a small field of view (FOV) was performed too. A both 2D and 3D-classification was applied on each resorption. After studying better the clinical aspect, especially the accessibility of the lesion, the restorability of the tooth was assessed and the approach was decided between external repair, with or without endodontic treatment, or internal repair. Reparative tissue was removed and the defect was managed through new generation composite resins, mineral trioxide aggregate (MTA) or other cements. A pulp capping was performed in one case and a canal treatment in the others. Clinical and radiographic checks assessed both quality and adequacy of the treatments immediately and over time. Key learning points: A standardized workflow could be useful for ECR treatment; CBCT is essential for determination of ECR extension and an appropriate treatment planning; ECR management should be conservative, but should also remove the reparative tissue; ECR management could be performed within one or two appointments; a follow-up is required to evaluate the treatment over time. The main outcome is the survival of the element, the secondary outcomes are the absence of resorption progression, no symptoms and healthy periodontal values.