15 years follow-up for a treatment of cervical invasive resorption

OBJECTIVES The purpose of this article is to present and discuss a case with a 15-year follow-up of invasive cervical external resorption (ICR) treated with an orthodontic and prosthetic approach. MATERIALS AND METHODS A 53-year-old female patient presents for regular professional hygiene check-ups, and during periodontal probing, an irregularity is noticed at the cervical margin of tooth 11. Despite subtle clinical signs and the absence of any symptoms, a defect is identified and investigated more closely. An intra-oral radiograph reveals a slight radiolucent area. Displacing the gingival tissue is revealed a subgingival cervical vestibular defect highlighted by a pinkish coloration. The diagnosis is external resorption. RESULTS AND DISCUSSION Invasive cervical external resorption is a relatively rare inflammatory pathology, challenging to diagnose as it often presents asymptomatically. The etiopathogenesis of this type of resorption is mainly associated with orthodontic treatments, trauma, or endodontic bleaching, but frequently the cause is unknown, describing various cases with idiopathic origin. In the literature, various treatment plans are proposed based on the defect’s location. However, for this case, a conservative orthodontic approach was chosen, involving extrusion, to expose the healthy root portion and using it prosthetically as support for a lithium disilicate crown with BOPT technique. CONCLUSIONS Addressing a case by focusing on preserving the residual dental structure and ensuring a lower biological cost to the patient should always be the clinical objective, even in particularly complex situations where invasive resorption seems to offer few possibilities for tooth recovery. CLINICAL SIGNIFICANCE Proposing a conservative treatment strategy with a 15-year followup for a condition that is often treated with more complex and invasive techniques.