Conventional endodontic therapy with surgical repair of an external resorptive defect.

Diagnosis and Treatment Considerations

• Resorption: External resorption

Patient presented with an asymptomatic, unrestored and vital mandibular first molar. Radiographic examination revealed invasive cervical external resorption on the mesial surface of the root extending below the alveolar crest. Cone Beam Computerized Tomography (CBCT) showed that this defect was extensive and communicated with the pulp. Depending on the size and location of the defect, teeth exhibiting external resorption can be very complex and difficult to treat predictably.

A multi-stage treatment approach, including both conventional endodontic therapy and surgical intervention was planned to try and obtain a successful outcome. After isolating the defect, endodontic treatment and a core build-up was placed. A surgical approach allowed complete removal of the resorptive tissue and restoration of the defect. One year follow-up shows excellent healing and the patient remains asymptomatic.