Department of Endodontology, King's College London Dental Institute, London, UK.
Specialist Practice, London, UK.
Int Endod J. 2018 Nov;51(11):1224-1238. doi: 10.1111/iej.12946. Epub 2018 Jun 9.
Effective management of external cervical resorption (ECR) depends on accurate assessment of the true nature and accessibility of ECR; this has been discussed in part 1 of this 2 part article. This aim of this article was firstly, to review the literature in relation to the management of ECR and secondly, based on the available evidence, describe different strategies for the management of ECR. In cases where ECR is supracrestal, superficial and with limited circumferential spread, a surgical repair without root canal treatment is the preferred approach. With more extensive ECR lesions, vital pulp therapy or root canal treatment may also be indicated. Internal repair is indicated where there is limited resorptive damage to the external aspect of the tooth and/or where an external (surgical) approach is not possible due to the inaccessible nature of subcrestal ECR. In these cases, root canal treatment will also need to be carried out. Intentional reimplantation is indicated in cases where a surgical or internal approach is not practical. An atraumatic extraction technique and short extraoral period followed by 2-week splinting are important prognostic factors. Periodic reviews may be indicated in cases where active management is not pragmatic. Finally, extraction of the affected tooth may be the only option in untreatable cases where there are aesthetic, functional and/or symptomatic issues.
有效的外部性牙颈部吸收（ECR）管理取决于对 ECR 的真实性质和可及性的准确评估；这在本文的第 1 部分中进行了讨论。本文的目的首先是回顾与 ECR 管理相关的文献，其次，根据现有证据，描述 ECR 管理的不同策略。在 ECR 位于牙颈部以上、表浅且局限于圆周的情况下，不进行根管治疗的手术修复是首选方法。对于更广泛的 ECR 病变，活髓治疗或根管治疗也可能是指征。如果牙齿外部的吸收损害有限，或者由于牙颈部以下 ECR 的不可触及性而无法进行外部（手术）方法，则需要进行内部修复。在这些情况下，也需要进行根管治疗。在手术或内部方法不切实际的情况下，需要进行有创再植入。采用无创伤拔牙技术和短的口腔外期，随后进行 2 周的夹板固定是重要的预后因素。在无法进行积极治疗的情况下，可能需要定期复查。最后，在存在美学、功能和/或症状问题且无法治疗的情况下，拔牙可能是唯一的选择。
