(TC49) Conservative Endodontic Management of Invasive Cervical Resorption: A Case Series

Abstract: Invasive cervical resorption (ICR) is a dynamic process comprising periodontal and, later, pulpal involvement with loss of hard tissues due to an odontoclastic process. Even though different authors have tried to elucidate the etiology of this type of resorption, ICR defects are poorly understood, leading to frequent misdiagnosis, under-reporting, and improper overall management. Diagnosing ICR defects can be challenging since patients are commonly asymptomatic; therefore, it may be an incidental clinical and/or radiographic finding. In fact, in the early stages, the pulp is not involved and is clinically diagnosed as normal. Therefore, vital pulp therapy (VPT) might be a viable treatment option in certain situations. Two particular cases, both asymptomatic incidental findings (Heithersay class II), will illustrate the usefulness of VPT strategies. In the first case (tooth #26), the access was done surgically with an intrasulcular flap to expose and curette the defect and a topical application of 90% trichloroacetic acid. A pulp exposure was observed, and Biodentine (Septodont, Saint-Maur-des-Fossés, France) was placed. In the second case (tooth #18), the defect was located on the mesial surface; due to lack of surgical access, the access was made internally with a sterile small bur, using Biodentine as a direct pulp cap material. On the subsequent follow-ups, both remain asymptomatic with a normal response to pulp testing. Both cases demonstrate that VPT might be a suitable alternative as a conservative option for small resorptive defects with the potential to preserve pulp vitality.