engleski

Surgical therapy of severe external cervical resorption in the aesthetic zone

Background: Root resorption is the loss of dental hard tissue (i.e., cementum, dentine and/or enamel) as a result of odontoclastic action. Root resorption in adult teeth is undesirable as it leads to irreversible damage, which may necessitate dental treatment, or even extraction. External cervical resorption (ECR) is a dynamic process that involves periodontal, dental and in later stages pulpal tissues. Orthodontic treatment, traumatic injury, internal bleaching, surgery and restorative treatment are the principle potential predisposing factors for ECR. Patients commonly are asymptomatic and diagnosed by incidental radiographic finding.Treatment options for ECR include the following external repair of the resorptive defect with or without endodontic treatment/retreatment. Description of the procedure: Female patient, age 21 was referred to our clinic with predominant symptom of swelling and pain in projection of upper left central incisor. Clinical examination showed purulent secretion from periodontal space. Probing depths were 8 mm isolated to area of swelling. Tooth mobility was not detected. Radiographic analysis using cbct showed large cervical resorption under the CEJ with communication with endodontic space. Management included mucoperiosteal flap, cleaning of the resorptive lesion and complete closure using bioactive material Biodentine (Septodont, Lancaster, PA, USA). In the second visit endodontic retreatment was done using R – Endo instruments (Micro – Mega, 12 Rue du Tunnel, 25, 000 Besançon, France) and for the aesthetic reasons superficial part of Biodentine was replaced with composite filling. (Clearfill Majesty ES – 2, Kuraray Noritake Dental Inc, Tokyo, Japan). Outcomes: Six month follow up showed complete healing, probing depths within physiologic limits without signs of gingival retraction or tooth mobility. Conclusions: Effective and predictable management of ECR depends on the accurate assessment of the true nature and size of the lesion. CBCT analysis means great progress in that direction. Complete removal of granulation tissue and repair of the defect with bioactive material increases chances for complete success of therapy.

Cervical root resorption, cbct, surgical therapy, bioactive materials

nije evidentirano