Root Resorption in the Furcation Area: A Differential Diagnostic Consideration

Abstract

This report describes the case of a 51-year-old female who was referred to a periodontist with a tentative diagnosis of complicated furcation defect in the facial aspect of the second permanent molar in the mandibular right quadrant. The clinical examination revealed an asymptomatic tooth without evidence of abnormal attrition, caries, or periodontitis. A closer assessment revealed a large concave lesion located close to the furcation entrance without being obviously connected to it. Periapical radiographs confirmed the presence of a lesion in the hard tissues of the root overlapping the furcation area, and radiolucency of the periapical area of the mesial and distal roots was observed. A tentative diagnosis of tooth fracture with consecutive supraosseous external root resorption was made, and exploratory surgery was performed to disclose the features of the lesion. The direct visual inspection revealed a deep round, conical lesion close to the entrance of the furcation. The base of the lesion was irregular but clean. After removal of a large amalgam restoration, a complete vertical mesio-distal fracture was disclosed. External root resorption can be found in the furcation area of mandibular teeth as a result of chronic inflammation. The radiolucent image is poorly delimited and departs from the well-delimited furcation involvement restricted to bone, which is a consequence of periodontitis. The careful interpretation of the clinical and radiographic signs can assist the clinician to differentiate the diagnosis of root resorption in the furcation area from furcation involvements that result from periodontitis.