Invasive Cervical Resorption of Uncommon Origin: A Case Report With 14-Year Follow-Up

Abstract

Background: Invasive cervical resorption (ICR) is a complex, relatively uncommon, and insidious phenomenon. Its occurrence is associated mainly with local predisposing factors, but systemic risk factors may be involved as well. An ICR lesion that develops in the absence of an identifiable cause is termed 'idiopathic'. Case report: This study presents the surgical management and very long-term follow-up results of an "idiopathic" Class 3 ICR lesion in the maxillary central incisor. The case provides a unique insight into an uncommon ICR lesion that exhibited an unusual appearance and features. For the repair material, a sandwich technique was applied using mineral trioxide aggregate (MTA) covered with glass ionomer cement (GIC). At the 14-year follow-up, the tooth was symptom-free and functional; however, the disadvantages of both materials were clearly demonstrated. From that perspective, the study highlighted the discoloration potential of the white form of MTA-Angelus and the lack of regenerative properties of the GIC used. Remarkably, 12 years after the surgery, the patient was diagnosed with Familial Mediterranean fever, a rare systemic disease. However, the connection between this genetic disease and the initiation of ICR remains an open question for now. Conclusion: The clinician should be alert for the occurrence of ICR lesions, especially in patients with concomitant systemic disorders. The right choice of appropriate repair material is a key factor for the healing outcome of ICR lesions in the anterior zone.