3D Diagnosis and management of external cervical resorption

Aim: This article reports the different clinical approaches of three external cervical resorptions (ECR) cases, based on a three-dimensional (3D) classification.

Summary: Treatment planning was based on a 3D diagnosis and the cone beam computed tomography (CBCT) was fundamental to do an accurate assessment of the extension of the lesions. The three cases presented different degrees of complexity, related to the extension of the resorption. In two cases, root canal treatment was performed and internal management of the resorptive lesion was accomplished. In a third case, with a more severe extension of ECR, surgical approach with flap elevation was done to access the resorptive defect. Minimum period of 6-months radiographic and clinical follow-up showed periapical and periodontal healing. This case report presents the importance of a correct 3D diagnosis and treatment planning in maintaining teeth with ECR.

Key learning points:

• ECR is a pathologic root resorptive process with an unclear aetiology. Beginning in a point of entry in the cervical area of the root, in later stages, the resorptive process can reach the pulpal space.
• Management of ECR lesions should be based on a 3D diagnosis, considering height, circumferential spread and proximity/involvement of the root canal.
• The use of CBCT enables the clinician to establish a proper diagnosis and evaluate the restorability of the tooth in question.