External Cervical Resorption – A Retrospective Case-Control Study
Dr. Mary Dabuleanu
Endodontist, North York, Toronto
In this episode of CDA Oasis Live, Dr. John O’Keefe, Director of Knowledge Networks CDA, invites Dr. Mary Dabuleanu, an endodontist from North York, Toronto, to discuss External Cervical Resorption.
Citing the recently published study External Cervical Resorption: A Retrospective Case-Control Study in the Journal of Endodontics, Dr. Dabuleanu walks through the systemic and local factors that are linked with the condition and highlights the key findings of the study.
Presenting her own case study, she takes a deep dive into the treatment of external cervical resorption and offers advice to general dentists on how to recognize and manage this somewhat rare condition.
Here are the key takeaways from the conversation…
- There is a significant link between both systemic and local factors, and cervical resorption. These factors include trauma, orthodontics, and medical conditions such as diabetes.
- Though it is not a common condition, by the time external cervical resorption is discovered, the teeth often have extensive defects.
- When doing exams and reviewing medical histories, dentists should be on the lookout for resorption which is often asymptomatic and can go unnoticed. There can be some gingival inflammation and localized bleeding on probing, as well as sensitivity.
- Defects are difficult to treat and usually require root canal treatment. Repair of defects often creates a gingival problem, a periodontal problem, and bone loss at the cervical third of the tooth.
- Treated teeth go from unrestored to heavily restored, which can be quite a shock to patients. Patient selection is very important.
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team
Resource
External Cervical Resorption: A Retrospective Case-Control Study
I have a question/comment. Photographic and radiographic evidence suggests this is a very compromised molar. The extent of the lesion involves the furcation. It is also stated that there was insufficient bone and/or tooth to properly recreate the Biologic Width. The claim is made by the presenter that the efficacy of the material used is supported in some circles and is thought to be “debatable” by others. It is also stated that this molar has a “guarded” long-term prognosis with regards to further restoration/tooth breakdown and chronic inflammation of the surrounding periodontium. This complicated endodontic procedure and surgical repair is both physiologically invasive and bears a considerable financial cost.
The statement is made that implant placement is “the best treatment for this patient”, but is contraindicated due to limited opening. Obviously, this patient has opened wide enough and long enough to allow for extensive endodontic therapy and surgical repair. Was an option for tooth extraction and placement of a traditional tooth supported 3-unit bridge presented to the patient? This is not mentioned in the presentation. The long-term prognosis of this option is stable in terms of decades and thus cost effective, even with an initial greater fee. In addition, with Scleroderma, the ability to open sufficient decreases with duration of the disease. Hence trying to prepare bridge abutments at a later time may prove more difficult, if not impossible, should tooth 46 fail.