Management of Heithersay's class II external cervical root resorption: A case report

Abstract

External cervical resorption (ECR), also known as invasive cervical resorption (ICR), is a rare and progressive form of tooth resorption that begins just below the cementoenamel junction and can lead to significant structural destruction if left untreated. This case report describes the diagnosis and management of ICR in a 32-year-old female presenting with intermittent pain in the maxillary left lateral incisor. Clinical and radiographic examinations, supported by cone-beam computed tomography (CBCT), confirmed a Heithersay Class 2 and Patel’s 3D classification 2Bp lesion. Treatment included nonsurgical root canal therapy combined with surgical removal of resorptive tissue, followed by restoration with mineral trioxide aggregate (MTA) and resin-modified glass ionomer cement (RMGIC). Calcium hydroxide was later used as an intracanal medicament, and obturation was completed with gutta-percha and a bioceramic sealer. At 12-month follow-up, the patient remained asymptomatic, with radiographic evidence of successful healing and no recurrence of resorption. This case highlights the importance of CBCT for accurate diagnosis and treatment planning, as well as the value of bioactive restorative materials in managing invasive cervical resorption.