Extra canal invasive resorption - Case 2 Case 1
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From: Yosef Nahmias
Sent: Tuesday, April 24, 2001 1:25 PM
Please look at this case!
Patient was referred to me for assessment of tooth #41 (FDI).
He is 27 years old.No symptoms at all. No history of trauma
(although he plays hockey!). Had extensive ortho done some
time ago! Medical OK! Distal Buccal pocketing 4 mm. Bleeding
upon probing. Tooth appears to be testing vital
(cold and Vitalometer!). No palpation, mobility and no
So now WHAT?
You know guys, it is incredible. One of you mentions that
they saw a broken instrument, next day I get one! Next day,
someone talks about a perforation, next day, I get one.
Is like the bad spirits are against me!
From: John J. Stropko, D.D.S.
Sent: Wednesday, April 25, 2001 9:23 PM
Looks like a classic radiographic appearance of Extra-Canal
Invasive Resorption. Get together with the top perio guy
in your area and discuss. I am guessing that you will lose
the tooth in spite of all attempts. Heard a talk by some
"flakey" periodontist Dr Eric Rindler)----just kidding Rick
---he was great!---last night at our local study club meetingt
He also is seeing more of this. A Dr Heathersay (sp?)
from Australia is supposedly THE expert on this.
Any other ideas?
Sent: Wednesday, April 25, 2001 10:25 AM
Invasive cervical resorption. Tx: eventual extraction,
as proper restoration will be tough! Otherwise, if judged
restorable, endo, cleaning of lesion w. trichloroacetic
acid, MTA or bonding, and prayers galore.
From: Fred Barnett
Sent: Wednesday, April 25, 2001 3:59 PM
I have a crazy idea for this type of resorption: how about
flap surgery, debridement of defects, EMDOGAIN, resorbable
membrane, flap replacement.
I thought Emdogain wasnt very predictable, no? - Jerry Avillion
From: Uziel Blumenkranz
Sent: Thursday, April 26, 2001 6:17 AM
Dear Yosi: If that is not an oblique crwon root fracture
it is a scaratch in your digital x ray? Invasive cervical
resorption, possibly post ortho. I saw some arrested
cases shown by Gerald Harrington, and I have a couple of
cases that seemed to have healed, however, how much are you
willing to gamble? Use Hiethersay's technique now
that the resorption has not advanced too much unless you can
get some previous X rays. let me know what happens. - Uzi
Yosef Nahmias wrote:
Thank you guys for the quick response! This case just showed
me AGAIN how important it is to be part of this group!!
THANKS A MILLION!
Photos courtesy of Yosef Nahmias - www.rxroots.com