Fifteen-year Clinical Follow-up of Restoration of Extensive Cervical Resorption in a Maxillary Central Incisor

Abstract

Internal bleaching in endodontically treated teeth requires care and protection to prevent harm to the periodontal ligament due to peroxide and may result in external root resorption. There is a myriad of treatment options when this occurs, such as monitoring, extraction, and subsequent rehabilitation with implants or fixed prosthodontics. In some cases, such as the one described here, a conservative attempt to maintain the tooth as a single structure can be made by sealing the resorptive defect. In the present case, we show a multidisciplinary approach where orthodontics, periodontics, and restorative dentistry were involved in treating the maxillary right central incisor (#8) of a 65-year-old patient with extensive cervical resorption, whose chief complaint was esthetics. The proposed treatment was extrusion of the tooth followed by curettage and restoration of the defect with glass ionomer cement. The patient has been followed for 15 years with no signs of recurrence, maintenance of periodontal health, and patient satisfaction with the esthetic outcome.

Clinical management of external cervical resorption: A systematic review

“…Orthodontic extrusion (OE) was described as an attractive alternative to surgery for exposing the ECR defect while preserving the osseous and gingival architecture [23,27,[46][47][48]. Smidt et al carried out the orthodontic extrusion of tooth 12 (H3) with two fiberotomies followed by a post and core prosthetic restoration and described the procedure as rapid, successful and a better choice to prevent attachment loss [48].…”

“…In all the other cases, orthodontic extrusion was uneventfully achieved in different modalities and over various time frames: from 80 days to 3 months, to 1 year, but without performing the fiberotomies. Among the disadvantages of OE, it was pointed out that, once extrusion had been completed, a crown lengthening procedure or a surgical flap was still required to treat the lesion [23,46,47].…”

Clinical performance of whitening on devitalized teeth: a retrospective observational study

“…The etiology of resorption has not yet been fully explained, and its reported incidence ranges from 1% to 13% [40][41][42]. Radiographic assessment did not show any process of radicular resorption regardless of the whitening technique (inside-outside), as indicated in previous studies by Amato and colleagues [13], Abbot and Heah [15], Kim and colleagues [43], Lise and colleagues [24] and Reston and colleagues [44], who performed evaluations after 1 to16 years of whitening.…”

Externe zervikale Frontzahnresorption – Zahnerhalt versus Ästhetik?

“…Die digitale Volumentomografie ist hier jedoch vorzuziehen, da neben der Pulpenbeteiligung auch die genaue Defektausdehnung und periapikale Veränderungen abgeklärt werden können [9]. [8,10,11]. Neuere Fallberichte zeigen auch die erfolgreiche Therapie mit Mineraltrioxidaggregat oder Biodentin [12,13].…”

“…Klasse I-II, evtl. III) kann der betroffene Zahn jedoch langfristig mithilfe konservativer Füllungstherapie erhalten werden[10,11]. Heithersay et al empfehlen die vollständige Entfernung des Granulationsgewebes und die Reinigung des Kavitätenbodens mit Trichloressigsäure unter absoluter Trockenlegung (Kofferdam; bei Beteiligung der Pulpa muss eine endodontische Therapie erfolgen) [8].…”