External Inflammatory Resorption Research Articles

Clinical and radiographic characterization of external root resorption.

The following bibliographic review was carried out with the purpose of recognizing the clinical and radiographic characteristics that must be considered in the diagnosis of external root resorption, including treatments. A bibliographic search was carried out in PubMed/Medline, Cochrane Library and Google Scholar databases under the term "external root resorption", from 2010 to 2022 in Spanish and English. Experimental studies and bibliographic reviews were selected, and finally 17 articles were included. The results obtained indicated that each type of resorption presents specific clinical characteristics that differentiate them, these are: for external inflammatory resorption a negative pulp vitality; for replacement external resorption the absence of mobility and metallic percussion; for cervical external resorption a pink coloration of the crown; superficial external resorption does not present any type of clinical symptoms and transient apical collapse presents a transient change in color. External root resorptions require accurate and early diagnosis. A clinical examination should be performed with emphasis on the following: probing, coloration, mobility, and vitality tests.

Intraoral Radiographic Interpretation Agreement Between Veterinary Students, Veterinary Dental Residents and Veterinary Dental Specialists.

This study evaluated observer variations in the interpretation of radiographic evidence for periodontal disease, tooth resorption, and endodontic disease in dogs. Forty dental radiographs were evaluated for 12 different parameters (periapical destruction of bone, wider than expected root canal, narrower than expected root canal, apical root resorption, loss of alveolar bone, external surface resorption, external replacement resorption, external inflammatory resorption, external cervical root resorption, internal surface resorption, internal replacement resorption, internal inflammatory resorption). Interpretations by 20 veterinary dentists, 10 veterinary dental residents, and 10 veterinary students were analyzed for consistency within groups and between groups by intraclass correlation coefficients (ICCs [95% CI]). Additionally, the agreement rate between groups compared to histopathological diagnosis, when available, and to a consensus group were evaluated. The results showed fair to good interobserver agreement for all participants when looking at all questions simultaneously (0.578 [0.515-0.635]) and with the consensus group (0.483 [0.451-0.517]). However, questions pertaining to various types of tooth resorption scored the lowest ICCs ranging from 0.005 (-0.311 to 0.321) to 0.189 (-0.105 to 0.402) across individual groups. Students had the lowest agreement compared to the consensus group for all questions (0.383 [0.347-0.421]) with fair to good agreement involving groups of residents (0.501 [0.465-0.538]), recently boarded diplomates (0.541 [0.506-0.578]), and more experienced diplomates (0.545 [0.510-0.582]). While dental radiographs are essential for clinical decision making, this study shows that interpretation of radiographs is highly subjective.

Indications for root canal treatment following traumatic dental injuries to permanent teeth.

The dental pulp may respond favourably or unfavourably to traumatic dental injuries. The most serious unfavourable responses are pulp necrosis and infection of the root canal system. These cause apical periodontitis and/or external inflammatory resorption of the tooth. The following injuries require root canal treatment as part of their emergency management-(A) complicated crown fractures (but some may be suitable for conservative pulp treatments, such as pulp capping, partial pulpotomy or pulpotomy), (B) complicated crown-root fractures, (C) supra-crestal coronal third root fractures and (D) injuries where pulp necrosis is predictable or highly likely to occur AND where there has been damage to the root surface and/or periodontal ligament with the aim of preventing external inflammatory resorption. This latter group of injuries are avulsion, intrusion, lateral luxation with a crown fracture, extrusion with a crown fracture (all in fully developed teeth) plus avulsion with a crown fracture and intrusion with a crown fracture (both in incompletely developed teeth). All other injuries should not have root canal treatment commenced as part of the emergency management, but they must be reviewed regularly to monitor the pulp for any adverse changes to its status, particularly pulp necrosis and infection of the root canal system.

Multidisciplinary Approach for Autotransplantation and Restoration of a Maxillary Premolar into an Area of an Avulsed Anterior Tooth: A Case Report with a 6-Year Follow-up

The loss of an anterior tooth because of avulsion has been reported in up to 3% of dental injuries. Management alternatives, such as implant-supported restorations and a fixed partial denture, are contraindicated in growing patients because of the continuous growth of the alveolar process. At the same time, orthodontic treatment for gap closure will result in asymmetry and will require adjustment of the adjacent healthy teeth. Therefore, restoring a missing tooth imposes a treatment challenge, especially in children and young adults. Tooth autotransplantation is a treatment modality with high reported survival and success rates that overcome these mentioned limitations. It might also help to preserve the alveolar bone and the soft tissues. This case report describes a multidisciplinary approach for managing a 13-year-old boy who lost his right maxillary central incisor because of a fall. Management included autotransplantation of the left maxillary second premolar to the site of the lost right maxillary central incisor, management of external inflammatory resorption with an endodontic treatment, orthodontic treatment, and aesthetic restoration of the area with composite resin crowns that can be adapted to the expected changes of the jaws during the craniofacial growing period. At the 6-year follow-up, the teeth demonstrated a positive outcome.

The outcomes of auto-transplanted premolars in the anterior maxilla following traumatic dental injuries.

Tooth auto-transplantation is a treatment option, which is often not considered to replace anterior maxillary incisors in children and adolescents. There are multiple prognostic factors that may influence the outcomes of premolar auto-transplantation, but there is limited evidence from human studies. The aim of this study was to report the outcomes of auto-transplanted premolars in the anterior maxilla following traumatic dental injuries (TDIs) and to identify their prognostic factors. The clinical records of patients who had premolars transplanted in the anterior maxilla following TDI, with appropriate radiographs and a minimal of 1-year follow-up, were reviewed retrospectively. A specific data extraction form was developed, tested and used to collect information for the prognostic factors and outcomes. The cohort included 120 patients with 144 auto-transplanted premolars. The mean age was 12.2 years (±2.0), and the mean observation period was 3.7 years (±1.8). The success rate was 80%, and the survival rate was 93%. Unfavourable outcomes included external replacement resorption in 12.5%, uncontrolled external inflammatory resorption in 2.7%, and both resorption types in 4.9% of teeth. Periodontal healing was significantly associated with donor tooth root maturity, graft handling at the time of surgery including ease of donor tooth extraction and placement at the recipient sites, recipient site alveolar bone status, and post-operative transplant mobility. Seventy-four teeth (53.4%) were immature at the time of transplantation where pulp revascularisation was anticipated, and 52 (70%) of those had radiographic and clinical signs of pulp healing. Pulp healing was significantly related to donor tooth eruption stage, ease of extraction of donor tooth, and ease of placement in the recipient site. Good outcomes were observed for premolar teeth auto-transplanted in the anterior maxilla. The main prognostic factors were ease of extraction of donor tooth and ease of placement in the recipient sites and donor tooth root maturity.

Treatment options for external inflammatory root resorption

Was to compare the efficacy of various treatment options for external inflammatory root resorption according to literature data. Literature was searched in electronic databases «eLibrary» and «PubMed» for key words «external inflammatory resorption treatment», «external inflammatory resorption management». Inclusion criteria comprised publications in Russian or English, clinical and experimental studies, full description of treatment protocol and obtained results. Studies with no full text, describing root resorption of orthodontic origin, clinical cases and clinical case series were excluded from the study. The problem of external inflammatory root resorption is poorly described in the Russian scientific literature. There are no registered protocols for its prevention and treatment or therapeutic agents with proved efficacy available in Russia. The only accessible approach for external inflammatory root resorption remains timely pulp extirpation after dental trauma which importance is underlined by all authors involved in the field of dental trauma studies. MTA and calcium hydroxide being popular as intracanal medications still have significant inconveniences as they potentially provoke root dentine fractures or replacement resorption. There is a need for elaboration and implementation of new prevention and treatment options for external inflammatory root resorption after dental trauma.

Pulp survival and periodontal healing of autotransplanted teeth: a retrospective study

Aim: The aim of this retrospective study was to evaluate the post-surgical results of autotransplanted teeth, considering the pulp survival rate and periodontal healing. Methodology: Records of 43 patients with 50 autotransplanted teeth were analysed. Demographic, clinical and radiographic data were verified. The time between autotransplantation surgery and the date of endodontic access was considered to assess the pulp survival rate. Periodontal healing was observed through gingival morphology and the presence of root resorption. Pulp survival was verified and the influence of Nolla stage on the survival rate was analysed. Results: The pulp survival rate was 72%, and the stage of root development influenced the survival rate in autotransplanted teeth (p = 0.001). The pulp survival rate in autotransplanted teeth in Nolla stages 6 and 7 was 100%; the pulp survival rate for teeth in stages 8 and 9 was 90% and 75%, respectively. Regarding periodontal analysis, no tooth was observed in the presence of periodontal pockets and mobility above grade I. Replacement resorption was diagnosed in 20% and external inflammatory resorption in 4%. Conclusions: Dental autotransplantation was a safe treatment, showing satisfactory results. The pulp survival rate was considered high, especially in teeth with incomplete rhizogenesis.

Management of invasive external cervical resorption in maxillary anterior teeth: A case report

The progressive breakdown of mineralized tooth tissue caused by overactive resorptive cells is known as root resorption. Root resorption can be divided into two types: Normal and pathologic. In most of cases of internal resorption and external inflammatory resorption root canal therapy is indicated. It may or may not be indicated in cases of invasive resorption, and it is not suggested in cases of replacement or pressure resorption (unless unrelated pulpal conditions necessitate endodontic intervention). Early detection and treatment of these defects might be beneficial to the patient and increase the chances of saving the tooth. In this case, report the description of external resorption post-orthodontic treatment has been restored and followed up and has shown a good prognosis.

Pattern of Root Resorption in Luxation Injuries in Permanent Incisors Presented to Restorative Unit , Institute of Oral Health, Maharagama – Sri Lanka

The aim of this descriptive study was to evaluate the association between root resorption and each type of luxation injury, the effect of timely treatment, age of the patient at presentation and maturity of maxillary anterior teeth presented with luxation injuries. A cross sectional descriptive study was carried out on 132 patients aged 6 to 50 years old with luxation injuries occurred to 213 teeth and were followed up for 24 months. Data were collected on the age, sex, the tooth/teeth involved, type of trauma, date of occurrence of trauma and date of presentation for treatment. Radiographically teeth were assessed for the presence/absence of resorption and type of resorption (External inflammatory, external replacement and Internal inflammatory) at review appointments. Data analysis was done using the SPSS version- 24 and non- parametric tests were used assess associations. Amongst all types of luxation injuries, most frequently presented type was subluxation (40.8%) injuries followed by concussion (25.4%), Intrusive and palatal luxation (15.5% each) and extrusive luxation (2.8%) respectively. Further, 51 of 213 teeth (23.9%) showed root resorption after luxation injury. The most frequently observed resorption was external inflammatory resorption in 44 teeth (20.7%) followed by external replacement resorption in 6 teeth (2.8%) and internal inflammatory resorption in 1 tooth (0.5%). Out of 43 late presenters 77% (34) showed root resorption, while only 10% (17) of immediate presenters showed resorption of root. The results indicated that there is a statistically significant difference in occurrence of root resorption and the late presentation for treatment (X2=91.63, df=3, p=0.000), as well as with the type of injury (X2=35.9, df=12, p=0.000). Furthermore, there was a statistically significant difference between the age of the patient and the type of luxation injury (X2 =54.29, df-12, P=0.000).

English

The periodontal ligament is a unique specialised connective tissue between the cementum covering the tooth root and the alveolar bone. It is believed that periodontal ligament cells are responsible for not only osteogenesis and osteoclasia of the alveolar bone but also for fibrogenesis and fibroplasia of the ligament itself, as well as cementogenesis and the presence of cementoblasts on the root surface. Injury to the periodontal ligament (PDL) and its compromised healing (external inflammatory resorption and replacement resorption) has been cited as one of the major reasons for the failure of transplantation and replantation procedures. The necessity of having a healthy PDL so that the tooth can re-attach and be retained in the socket determines the prognosis of replanted teeth. Thus, the importance of maintaining the periodontal viability has led to an increased interest in the development of platelet concentrates, which have been considered as autologous biomaterials having the ability to potentiate healing, repair, and regenerate. PRF (platelet rich fibrin) is a living biomaterial derived from human blood containing fibrin, platelets, growth factors, leukocytes and stem cells entrapped in a fibrin-based scaffold / matrix, which has been documented to promote bone and soft tissue healing and regeneration. PRF technology has grabbed the attention of clinicians because it is readily available, is easy to prepare, can be produced immediately at the chairside, is easy to use, and widely applicable in dentistry, while being financially realistic for the patient and the clinician. Thus, the purpose of this review is to enumerate the biologic, chemical and physical properties of PRF and highlight the essential role it plays in periodontal regeneration and repair, which can be highly beneficial in improving the treatment success rate of transplantation and replantation procedures. KEY WORDS Platelet Rich Fibrin, Replantation, Transplantation, Periodontal Ligament, Periodontal Regeneration

Oral and Dental Examination Findings in European Polecats (Mustela putorius)

Dental and oral diseases in the domestic ferret have been reported, but comparison with their closest wild relative, the European polecat (Mustela putorius), is lacking. Dental and orofacial pathology was evaluated by means of visual examination and dental radiographical analysis of 234 museum skulls. Most of these (70.5%) originated from Austria and the remainder came from seven other European countries. Linguoverted mandibular second incisor teeth were noted in 77% of the skulls. There were 7,268 (91.4% of all potential) teeth available for examination. Few (0.3%) were presumed congenitally missing and 0.5% were presumed missing by acquired means. Supernumerary teeth were present in 2.6% of the skulls. Most (65.6%) of the maxillary first molar teeth were three rooted with the palatal root protruding into the orbit. Most (67.2%) of the mandibular first molar teeth were three rooted with the smaller third root being positioned in the furcation of the two larger roots. Thirty-one percent of the teeth were four rooted, with the smaller fourth root also being positioned in the furcation of the two largest roots. Attrition/abrasion was shown by 17.2% of the teeth in 47% of the skulls. Periodontitis was recognized in 57.6% of the teeth in 91.9% of the skulls and dental fractures were noted in 7.2% of the teeth in 62% of the skulls. Radiographical evidence of endodontic disease was found in 25% of the fractured teeth. Tooth resorption, in the form of external inflammatory resorption associated with endodontic disease, was found in 0.1% of teeth in 2.1% of skulls. Extrusion affected 44% of the canine teeth. Lesions consistent with infection by the helminth Troglotrema acutum were identified in 33.3% of the skulls. Oral and dental disease was significant and varied, often consistent with reports of the species domestic counterpart - the ferret. Comparison with other mustelids, notably the beech marten (Martes foina), showed both clear consistencies and discrepancies, dependent on the type of pathology.

Management of root canal stenosis and external inflammatory resorption by surgical root reconstruction using biodentine

Root canal stenosis and external inflammatory root resorption are potential consequence of trauma that can occur depending on the severity of the injury. Luxation injuries induce reduced blood supply to the pulp, which leads to calcification/narrowing of root canals leading to root canal stenosis. External inflammatory cervical resorption occurs when there has been the loss of cementum due to damage to the external surface of tooth root during trauma, plus root canal system becoming infected with bacteria. External inflammatory resorption can ultimately lead to loss of tooth if it is not managed in a timely manner. The treatment should aim toward the complete suppression of all tissues undergoing resorption and the reconstruction of the resorptive defect by the placement of a suitable bioactive material. This case report presents the management of root canal stenosis in the maxillary left central incisor in 35-year-old female and management of Class IV external invasive cervical and apical inflammatory resorption in maxillary right central incisor, both of which were diagnosed with the help of cone-beam computed tomography scan. The treatment of external inflammatory resorption included surgical excision of granulation tissue and root reconstruction with Biodentine. Twelve months follow-up showed successful outcomes for both the teeth treated for root canal stenosis and external invasive inflammatory resorption leading retention of the traumatized teeth with otherwise poor prognosis.

Diagnosis and Management of Multiple External Inflammatory Root Resorption of Maxillary Central Incisor Using Cone Beam Computed Tomography-A Case Report

Avulsion and replantation of the teeth following traumatic injury causes complication such as inflammatory and replacement resorption. This case report describes a traumatic injury to the permanent maxillary central incisor exhibited pulpal necrosis leading to periapical cyst with massive bone loss and extensive external inflammatory root resorption. Endodontic therapy and surgery was performed to salvage the tooth with poor prognosis. The multiple resorptive defects were debrided and restored with resin modified glass ionomer cement. The postoperative follow-up revealed improved healing. The prognosis of the tooth which was badly destructed due to external inflammatory resorption was greatly enhanced with appropriate treatment plan and ultimately increased the longevity of the tooth.

Oral and dental anomalies in purebred, brachycephalic Persian and Exotic cats.

OBJECTIVE To determine the prevalence of dental anomalies in brachycephalic cats from various geographic regions and analyze potential relationships with oral disease. DESIGN Prospective multicenter cross-sectional study. ANIMALS 50 purebred Persian (n = 42) and Exotic (8) cats. PROCEDURES Cats were anesthetized, and a complete dental examination, dental charting, 3-view oral photography, and full-mouth dental radiography were performed. RESULTS Malocclusions were observed in 36 (72%) cats. Crowding of the teeth was evident in 28 (56%) cats, with the incisors being most commonly affected. Malpositioned teeth were noted in 32 (64%) cats, with abnormal orientation being the most common anomaly followed by rotation and impaction. Numerical abnormalities were present in 38 (76%) cats, including 6 (12%) with hyperdontia and 32 (64%) with hypodontia. Periodontal disease was reported in 44 (88%) cats, and cats with periodontal disease were older than cats without. Tooth resorption was evident in 35 (70%) cats. Overall, 123 of 1,349 (8.7%) teeth had external inflammatory resorption and 82 (6.1%) had external replacement resorption. The premolar teeth were the teeth most commonly affected with inflammatory resorption, whereas the canine teeth were the teeth most commonly affected with replacement resorption. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that because of their brachycephaly, Persian and Exotic cats have unique oral and dental features that may predispose them to dental disease (eg, tooth resorption and periodontal disease). Knowledge of the particular dental anomalies common in brachycephalic cats could aid in early detection and mitigation of dental disease in these breeds.

Relationship between Initial Attendance after Dental Trauma and Development of External Inflammatory Root Resorption.

This clinical study aimed to evaluate the relationship of the delay between dental trauma and the initial attendance to the development of external inflammatory root resorption in permanent teeth affected by severe luxation. Sixty-seven patients, aged between 11 and 56 years, presenting 133 injured teeth with closed apex (56 extrusive luxation, 69 lateral luxation and 8 intrusive luxation) were followed up for a minimum of 24 months. The time elapsed between dental trauma and the initial attendance was recorded. The presence of necrotic pulp and external inflammatory resorption for each type of trauma was verified. Fisher's exact test was used to verify the influence of the initial attendance date at the Dental Trauma Center and the development of inflammatory resorption (p<0.05). The odds ratio was used to check the risk of developing external inflammatory resorption due to delay in seeking treatment. Pulp necrosis was observed in 105 teeth (78.9%) and external inflammatory resorption was detected in 17.8% cases of extrusive luxation (10 teeth), 15.9% of lateral luxation (11 teeth) and 25% of intrusive luxation (2 teeth). For lateral luxation, extended delay between the date of injury and initial attendance influenced the occurrence of external inflammatory resorption (p=0.0174). Patients who began treatment 45 days after the injury were 3.4 times more likely to develop external inflammatory resorption than patients who sought treatment after the trauma. Treatment late after the occurrence of dental trauma can impair the prognosis and result in the development of external inflammatory resorption in luxated teeth.

Radiographic evaluation in clinical practice of the types and stage of incisor tooth resorption and hypercementosis in horses.

There are several reports of incisor tooth resorption and hypercementosis in horses but, to date, studies have been limited in case numbers and to advanced lesions. Tooth resorption in other species is a radiographic diagnosis of types of resorption that are often identified before clinical signs. Our goal was to evaluate radiographically incisor tooth resorption in a large population of horses, utilising interpretation criteria from canine and human dentistry. To document and classify incisor tooth resorption and hypercementosis. Retrospective descriptive case series. Horses presented for routine dental care >5 years old were included only if owners were unaware of incisor pathology. Radiographs (three views) were obtained of the incisor teeth and incisor teeth resorption was classified according to the radiographic criteria described for man and dogs. Hypercementosis and its location were recorded. Tooth resorption was detected in 149 of 169 (88.2%) horses and 951 of 1952 (48.7%) of incisor teeth. The classification system used was applicable in 926 (97.2%) of 951 affected teeth. Hypercementosis was detected in 34 (20.1%) horses and 148 (7.6%) teeth. As horses increased in age, resorption and hypercementosis was more frequent; no significant differences were found among sex or breed categories. All horses with hypercementosis had resorption, but only 23.4% of horses with resorption had hypercementosis. Advanced (stage ≥3) resorption was detected in 159 (8.1%) teeth and 54 (32.0%) horses in an otherwise clinically healthy population. Certain horses' anatomy precluded isolation of the mandibular third incisor teeth from the canine teeth due to superimposition. Incisor tooth resorption, in particular external replacement resorption and external inflammatory resorption, is common in horses. Hypercementosis is consistently associated with resorption, but the inverse association is inconsistent.

Prevention and management of external inflammatory resorption following trauma to teeth.

External inflammatory resorption is one of the potential consequences of trauma to the teeth. It occurs when there has been loss of cementum due to damage to the external surface of the tooth root during trauma, plus the root canal system has become infected with bacteria. It is characterized by the radiographic appearance of loss of tooth substance with a radiolucency in the adjacent periodontal ligament and bone. The loss of cementum allows the intracanal bacteria and/or their endotoxins to reach the periodontal ligament more readily and this can lead to the development of the inflammatory resorptive process. External inflammatory resorption can ultimately lead to loss of the tooth if it is not managed in a timely manner. There are some injuries that are very likely to develop this type of resorption and a preventive approach can be adopted by commencing root canal treatment immediately as part of the emergency management of such cases. In cases where the resorptive process is already established, root canal treatment can arrest the resorption and encourage hard tissue repair. The use of a corticosteroid-antibiotic intracanal medicament has been shown to be particularly useful in the prevention and management of external inflammatory resorption. Calcium hydroxide should not be used as an immediate medicament because of its inherent toxicity and irritant properties but it is valuable as a subsequent medicament to encourage hard tissue repair where required. This review outlines the external inflammatory resorptive process and the management strategies that can be employed to prevent it from occurring, and to treat it if already present.

Prevalence and types of tooth resorption in dogs with oral tumors

To determine the prevalence and types of tooth resorption in dogs with oral tumors and to compare findings with those for control dogs. 101 dogs with oral tumors and 128 control dogs that did not have oral tumors and for which dental radiographs were available. Exclusion criteria for dogs included systemic disease, long-term administration of anti-inflammatory drugs, traumatic occlusion, severe semigeneralized or generalized periodontitis, and endodontic disease. For each dog with an oral tumor, histologic sections of biopsy specimens of tumors were examined. Dental radiographic images of dogs were examined, and the presence and type of tooth resorption were determined for each tooth. Statistical analyses were performed to compare data regarding prevalence of tooth resorption. Teeth at tumor sites in dogs with nonodontogenic tumors were significantly more frequently affected with external inflammatory resorption, compared with teeth at tumor sites in dogs with odontogenic tumors. Teeth at sites distant from tumors in dogs with oral tumors were 3.2 times as likely to have external surface resorption (OR, 3.2; 95% confidence interval, 1.3 to 7.9) and 83.4 times as likely to have external inflammatory resorption (OR, 83.4; 95% confidence interval, 9.7 to 719.6) as teeth in control dogs. Resorption of teeth at tumor sites and at sites distant from tumors was common in dogs with oral tumors. Results of the present study will contribute to an understanding of the complex effects of oral tumors on local and distant hard tissues.

A 5-year follow-up case of multiple intrusive luxative injuries

Introduction: Traumatic intrusive luxation is one of the most severe forms of dental injuries, usually affecting the maxillary incisors. The consequence of such an occurrence is a high risk of healing complications such as pulp necrosis, external inflammatory resorption, and external replacement resorption (ankylosis). Case Report: This report presents a case of severe intrusive luxation of multiple anterior teeth in an 11-year-old girl. The teeth were repositioned successfully by endodontic and orthodontic management. The case was monitored for 5 years. Discussion: Depending on the severity of the injury, different clinical approaches for treatment of intrusive luxation may be used. Despite the variety of treatment modalities, rehabilitation of intruded teeth is always a challenge and a multidisciplinary approach is important to achieve a successful result. In this case, intruded teeth were endodontically treated with multiple calcium hydroxide dressings and repositioned orthodontically. The follow-up of such cases is very important as the repair process after intrusion is complex. After 5 years, no clinical or radiographic pathology was detected.

Internal and external resorption in a lower molar with an associated endodontic-periodontic lesion: A case report

This article describes a unique case in which both internal and external inflammatory resorption and endodontic-periodontic lesions were present at the same time in the patient's left mandibular first molar. Based on clinical and radiographic findings, it was determined that the nature of this case was a pulpal infection-induced inflammatory resorption and furcation lesion. After root canal therapy, the furcation lesion and external inflammatory resorption were completely resolved. This case indicates that the correct diagnosis of the stimulating factor for tooth resorption and determination of the primary origin of endodontic-periodontic lesions are critical for clinical management and success.