Presentation Category
Research
Introduction/Context/Diagnosis
Invasive cervical resorption (ECR) is a complex form of external resorption. It is distinguished by its localization, its invasive nature, and the formation of a mineralized replacement tissue resembling cellular cementum. During initiation of ECR, the portal of entry is the cementum below the gingival epithelium, and resorption starts with localized destruction and removal of PDL. Response to PDL injury includes formation of a blood clot and inflammation, followed by granulation tissue, recruitment of macrophages, and multinucleated-cell differentiation.
Methods/Treatment Plan
Using keywords such as external cervical resorption, histopathology, osteoclastogenesis in PubMed search engine, pertinent literature was obtained. The review aims to summarize the latest findings on ECR to provide an evidence-based reference for clinicians.
Results/Outcome
The etiology and pathogenesis of ECR are largely obscure. A hypothesis regarding its development claims that a local discontinuity of the protecting layer of radicular cementum renders the subjacent dentin accessible for osteoclasts. Voids in cementum and dentin frequently occur in the cervical root areas close to CEJ. These voids can arise as a primary malformation of enamel-cementum closure or secondarily result from a physical or chemical trauma. The presence of inflammatory cells is not necessarily indicative of a microbiological etiology and there are cases in the literature, which show no inflammation. These cases, coupled with the clinical manifestations, indicate that invasive cervical resorption is an aseptic resorptive process, which may on occasions become secondarily invaded with microorganisms. ECR is mainly characterized by 3 major stages: resorption initiation, resorption progression, and repair.
Significance/Conclusions
The exact correlation between factors and the initiation of ECR has not yet been fully elucidated because of our insufficient understanding of ECR pathogenesis. Further research on etiology, especially the underlying mechanism of various predisposing factors and the vulnerability of exposed dentin in injury, may provide pragmatic guidance for clinical practice.
Format
Event
A Review of External Cervical Resorption
Invasive cervical resorption (ECR) is a complex form of external resorption. It is distinguished by its localization, its invasive nature, and the formation of a mineralized replacement tissue resembling cellular cementum. During initiation of ECR, the portal of entry is the cementum below the gingival epithelium, and resorption starts with localized destruction and removal of PDL. Response to PDL injury includes formation of a blood clot and inflammation, followed by granulation tissue, recruitment of macrophages, and multinucleated-cell differentiation.
