Multiple idiopathic invasive cervical root resorption

MICRR is a rare disease affecting more than 3 teeth at a time and is known to gradually involve other teeth. The etiology of this progressive disease is unknown and is usually detected as an incidental radiographic finding. This article reports one such case involving 5 teeth in a 25 year old healthy male patient who reported the chief complaint of discomfort and vague dull pain in the left mandibular posterior tooth for 3 months. Intraoral examination revealed initial occlusal pit caries on mandibular left first molar (#36) with grade I mobility, which was nontender on percussion with no vestibular findings. A panoramic radiograph showed a well defined radiolucent lesion in the cervical region on the mesial and distal surfaces of tooth #36 and the distal cervical areas of mandibular left first (#34) and second premolar (#35). Tooth #36 was extracted due to poor prognosis and subjected to histopathological investigation, scanning electron microscopy (SEM), and energy dispersive X ray (EDX or EDS) analysis. Histopathological evaluation showed cervical resorption with surface resorptive irregularities with vacuolar changes, and SEM revealed areas of lacunar resorption with irregular borders. Results of EDX analysis showed atomic % of calcium (CA) and phosphate (P) of 4.8% and 3.4%, respectively, with a CA: P ratio of 1.41:1.