Mashyakhy Mohammed, Chourasia Hemant R, Halboub Esam, Roges Rafael A, Gambarini Gianluca
Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia, Phone: +966557224154, e-mail:
Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.
J Contemp Dent Pract. 2018 Sep 1;19(9):1152-1156.
Invasive cervical resorption (ICR) is a relatively uncommon form of external tooth resorption, characterized by an invasive nature. It is usually painless and detection of lesions is often made incidentally. Three-dimensional imaging techniques, such as cone beam computed tomography (CBCT), are useful in the diagnosis and management of ICR as the true extent of the defect cannot always be estimated using conventional radiographs.
The aim of this article is to report on the successful treatment of ICR in mandibular first molar by nonsurgical approach and follow-up by means of CBCT.
An 18-year-old patient was referred with a complaint of unusual radiolucency in the mesial cervical area of tooth #19 with unknown etiology. Cone beam computed tomography was performed to assess the extent of the lesion in three spatial levels and diagnosis of Heithersay class III ICR was made. This case presented with ICR (Heithersay class III) on tooth #19. Nonsurgical root canal treatment and removal of the lesion from the coronal access was performed; the resorptive defect was filled with dual-cure, self-adhesive, resin-modified glass ionomer cement (RMGIC); 6-month follow-up X-ray film showed no changes at the lesion site and tooth was asymptomatic; 1-year follow-up X-ray film showed slight mesial bone loss and a probing depth of 3 mm; finally, 2-year follow-up CBCT images showed no recurrence and no further bone destruction at the lesion site.
The intraoral radiographs revealed the resorptive changes in two dimensions; therefore, the actual extent and location of the lesions are not fully understood. On the contrary, CBCT is a very useful tool to achieve a proper diagnosis; it detects the extent of the defect more accurately and hence, improves the treatment outcomes of ICR.
The ICR is usually seen as a late complication to traumatic injuries of the teeth; it is essential, therefore, that the patients who were exposed to situations that can damage the integrity of periodontal tissue need to have careful periodic recalls and X-ray examinations.
侵袭性颈部牙吸收（ICR）是一种相对少见的牙齿外部吸收形式，具有侵袭性。它通常无痛，病变常为偶然发现。三维成像技术，如锥形束计算机断层扫描（CBCT），在ICR的诊断和治疗中很有用，因为使用传统X线片往往无法准确估计缺损的实际范围。
本文旨在报告通过非手术方法成功治疗下颌第一磨牙ICR并借助CBCT进行随访的情况。
一名18岁患者因19号牙近中颈部区域出现不明原因的异常透射区前来就诊。进行锥形束计算机断层扫描以评估病变在三个空间层面的范围，并诊断为海瑟西III类ICR。该病例为19号牙出现ICR（海瑟西III类）。进行了非手术根管治疗并从冠部入口处去除病变；用双固化、自粘接、树脂改性玻璃离子水门汀（RMGIC）填充吸收性缺损；6个月的随访X线片显示病变部位无变化，牙齿无症状；1年的随访X线片显示有轻微的近中骨质丧失，探诊深度为3mm；最后，2年的随访CBCT图像显示病变部位无复发且无进一步骨质破坏。
口腔内X线片显示了吸收性改变的二维情况；因此，病变的实际范围和位置并未完全明确。相反，CBCT是实现准确诊断的非常有用的工具；它能更准确地检测缺损范围，从而改善ICR的治疗效果。
ICR通常被视为牙齿外伤的晚期并发症；因此，对于那些曾暴露于可能损害牙周组织完整性情况的患者，必须进行仔细的定期复查和X线检查。
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