(TC13) Treatment Options for Teeth with Class III and IV Invasive Cervical Resorption Lesions

Abstract: Invasive cervical resorption (ICR) has become an increasingly observed clinical phenomena that is not well understood and often misdiagnosed or undiagnosed. The purported etiology, whether it's history of orthodontic treatment, trauma or owning domestic cats with feline odontoclastic resorptive lesions, also remains a topic for debate and remains elusive to the endodontic community. Early diagnosis and decision making are essential to the predictable and successful management of ICR. However, since the majority of patients with ICR lesions are asymptomatic, the diagnosis can be delayed until an incidental finding is discovered on radiographs, the patient complains of a pinkish appearance of the crown or presents with symptoms of pulpitis or apical periodontitis. With delayed diagnosis, ICR can progress undetected with destructive and untreatable Class III or IV stages. When patients present with advanced ICR lesions, the practitioner must provide the patient with all possible treatment options with risks and benefits. Class III or IV ICR lesions often appear on anterior teeth, an internal approach to treatment can be a great clinical technique to preserve the patient’s anterior esthetics. The purpose of this table clinic is to review the treatment options for teeth with Class III or IV invasive cervical resorption. When intervention becomes necessary, an internal approach appears to be the main treatment modality to retain the involved tooth. With the knowledge of this approach, clinicians will be able to better select patients for treatment, render the proper treatment, and benefit the patient by preserving tooth structure, soft tissue, and esthetics.