Management of cervical external root resorption following connective tissue grafting

Background

Cervical external root resorption (CERR) is not a common occurrence, but can result in a hopeless tooth prognosis. Its etiology is poorly understood and its management can be challenging. The present case report describes the late presentation and management of CERR at both maxillary first premolar teeth following connective tissue grafting (CTG) procedures including use of citric acid as a chemical root surface conditioner.

Methods and Results

A 55-year-old female was diagnosed with bilateral external cervical root resorption of both maxillary first premolar teeth 28 years after CTG procedures that had included the use of citric acid root conditioning. As both teeth were asymptomatic, the patient opted for repair of the lesions via full-thickness flap elevation, meticulous removal of all granulation tissue, and restoration of the lesions with a resin-modified glass ionomer. A 2-year follow-up has been completed with no significant complications to report.

Conclusions

CERR usually develops asymptomatically and is found by chance in radiographs. Its etiology is unclear, but may appear some years after soft tissue grafting to manage gingival recession. Early detection is key to be able to repair the lesions with minimal intervention.