Non Surgical Management of Class I Invasive Cervical Resorption and Anterior Aesthetic Rehabilitation: A Case Report with 2-Years Follow-Up

Abstract

Amongst all the types of external resorption, External Cervical Resorption (ECR) is the least understood. ECR usually encompasses the cervical region of the tooth and is located immediately below the epithelial attachment. The diagnosis and management of ECR defects is usually difficult. However, a comprehensive knowledge pertaining to the true nature and exact location of the defect helps achieve effective management and render appropriate treatment. Advancements in digital imaging like Cone Beam Computed Tomography (CBCT) have made possible, the diagnosis of pathological lesions like ECR with greater precision. Here we report a case of 21-years old male patient, treated with the successful retreatment of maxillary central incisor along with the non invasive management of ECR associated with the tooth. The patient presented with a history of spontaneous pain in respect to maxillary left central incisor and punched out radiolucent lesion was evident on the disto-cervical aspect radiographically. It also revealed an incomplete endodontic treatment. As the patient was not willing for any surgical intervention, conservative non-surgical endodontic re-treatment was performed which involved long term calcium-hydroxide therapy. At two years follow-up, the patient remained asymptomatic demonstrating radiographic evidence of bone-like tissue filling the resorptive defect. The clinical implications of this paper aim at an appropriate diagnosis of the resorptive lesion using three dimensional (3D) imaging techniques and a conservative non surgical long term calcium-hydroxide therapy for the management of ECR. The endodontic treatment was further followed by aesthetic rehabilitation for the asymmetric smile correction using minimally invasive technique of EMax crowns.

Keywords

• calcium hydroxide
• dental aesthetics
• external resorption
• root resorption
• tooth discoloration