Invasive cervical root resorption: Engineering the lost tissue by regeneration

Successful Management of an Extensive Class V Carious Lesion With Dehiscence and Loss of the Attachment Apparatus: A Case Report With Six-Month Follow-Up

The present case report presents a rare instance of a Class V carious lesion combined with alveolar dehiscence in a non-vital maxillary central incisor without gingival recession. A 25-year-old male exhibited symptoms, including a blackened tooth (#21), pus discharge, and tenderness, with clinical examination revealing a Class V carious lesion and partial dehiscence of the labial cortical plate, confirmed by radiographic and cone-beam computed tomography (CBCT) imaging. Treatment involved a two-phase approach: endodontic therapy with root canal instrumentation and obturation using a bioceramic sealer, followed by surgical intervention that included carious lesion removal, restoration with resin-modified glass ionomer cement (RMGIC), and application of a platelet-rich fibrin (PRF) membrane. PRF was selected for its regenerative properties, promoting bone healing and tissue repair, and was particularly beneficial in extensive lesions. Post-treatment follow-up at six months demonstrated complete soft tissue healing, reduced probing depth, and significant bone regeneration. This case illustrates the effective management of a complex dental condition through a combined endodontic and periodontal approach enhanced by PRF therapy, yielding favorable clinical and radiographic outcomes.

Clinical management of external cervical resorption: A systematic review

This review investigated whether any therapeutic options influenced the outcome of treatment for teeth with external cervical resorption. Out of 870 articles identified by an electronic search, 60 clinical case reports and six case series were included. No randomised clinical trials were found. Risk of bias was assessed using Joanna Briggs Institute's tools. External surgical intervention was the preferred method of accessing the lesions. Removal of resorptive tissue was most often achieved mechanically. Bioactive endodontic cements were the preferred materials for restoring teeth. The outcome measures were based on clinical and radiographic parameters. Of the cases included in the review, no specific treatment approach had a superior outcome in relation to Heithersay's classification. Furthermore, due to the absence of randomised clinical trials, and the low level of evidence associated with case reports/case series, it was not possible to define the optimum clinical treatment for external cervical resorption.