Multidisciplinary management of an external cervical resorption and cemental tear

Abstract

A 53-year-old man was referred to the University Dental Clinic complaining of a pink spot that he noticed on his right maxillary central incisor. After thorough clinical and radiographic examination, including (FOV) cone-beam computed tomography (CBCT), revealed an external cervical resorption (ECR) classified as class 3Bp in tooth 11 and a probable cemental tear on tooth 21. A root canal treatment was performed on tooth 21 using a single master gutta-percha cone and a bioceramic sealer (Bioroot™ RCS). Subsequently, due to the extent of the ECR lesion, a combined internal and external approach was planned for tooth 11. The treatment consisted of raising a modified papilla preservation technique over the ECR lesion of tooth 11, followed by a complete rubber dam isolation, using trichloroacetic acid 90%, and blocking the canal with a single gutta-percha cone. The defect was then restored with a resin modified glass ionomer cement (Geristore®). A simplified papilla preservation technique was then extended to treat the cemental tear on tooth 21, within the same intervention, after which the root canal treatment for tooth 11 was completed. A 10-months follow-up examination showed a successful outcome of the apical radiolucency of tooth 21 with clinically stable gingival margins and no further evidence of ECR recurrence.