SURGICAL MANAGEMENT OF EXTERNAL CERVICAL RESORPTION AND RADICULAR CYST OF AN ENDODONTICALLY TREATED TEETH

Background: External cervical resorption (ECR) is a pathological process often associated with trauma or dental procedures, leading to the loss of tooth structure. When accompanied by periapical pathology such as a radicular cyst, management becomes complex, particularly in previously endodontically treated teeth. Cone-beam computed tomography (CBCT) plays a crucial role in accurately diagnosing and delineating such lesions.

Case Presentation: A 27-year-old male presented with cavitation and swelling in the upper right central (11) and lateral incisor (12) regions, both of which had been previously endodontically treated. Clinical and radiographic evaluation revealed Class 2Bd external cervical resorption in 11 and a large periapical lesion suggestive of a radicular cyst in 12. CBCT imaging confirmed the extent of the resorptive and cystic involvement.Surgical intervention included application of trichloroacetic acid to the resorptive defect, thorough curettage, and enucleation of the cystic lesion. The resorptive defect and retrograde root ends were restored with mineral trioxide aggregate (MTA), and bone grafting was performed in the periapical area of 12. Minor gingival recession was managed postoperatively with composite restoration.

Conclusion: At one year follow up, both teeth showed healthy periodontal conditions and complete radiographic healing. This case highlights that meticulous surgical debridement combined with bioactive restorative materials like MTA can successfully manage complex cases of external cervical resorption and radicular cysts in previously treated teeth.