Surgical Management of an Advanced Case of Invasive Cervical Root Resorption: A Case Report.

External cervical resorption (ECR) is a pathological condition characterized by progressive loss of tooth structure, often remaining asymptomatic until reaching an advanced stage. The condition can have a multifactorial origin, with possible contributing factors such as trauma, orthodontic movement, and microbial activity. Early diagnosis through advanced imaging techniques such as cone-beam computed tomography (CBCT) is crucial for optimal treatment planning and prognosis. This case report describes the surgical management of a severe ECR lesion affecting a maxillary anterior tooth in a 45-year-old female who presented with pain and localized swelling. Clinical and radiographic evaluation revealed an invasive cervical resorptive lesion with pulpal involvement. Surgical intervention included meticulous removal of resorptive tissue, chemical cauterization using 10% trichloroacetic acid for decontamination, and restoration of the defect with Biodentine (Septodont, St Maur-des-Fossés, France). Following root canal therapy and definitive restoration, the patient was reviewed periodically. At the one-year follow-up, she remained asymptomatic with no clinical or radiographic signs of recurrence. The Biodentine restoration exhibited excellent adaptation, and CBCT confirmed successful treatment with no further resorptive progression.