External cervical resorption: diagnostic and treatment tips

ABSTRACT External cervical resorption is caused, almost exclusively, by dental trauma - especially those characterized by concussion - and is a dental disease to be diagnosed and treated accurately by endodontists. However, the vast majority of the cases is initially diagnosed by an orthodontist, due to the imaging possibilities in standardized documentations. Among the causes of external cervical resorption, it is common to mistakenly attribute it to orthodontic treatment, traumatic occlusion or even to chronic inflammatory periodontal disease. External cervical resorption is associated to dental trauma in several situations mentioned in this paper. In old cases, and eventually still nowadays, it may have been induced by internal tooth bleaching, which is increasingly less frequent in endodontically treated teeth. There are some tips to be followed and some care that must be taken during the diagnosis and treatment of external cervical resorption clinical cases. The present study lists foundations that will allow the professional to perform safely and accurately in each specific case. Some of these tips and care measures are of orthodontic nature.

摘要：外宫颈型牙体吸收（External Cervical Resorption）几乎均由牙外伤引发，其中以牙震荡为主要致病类型，该疾病需由牙髓病专科医师（endodontists）进行精准诊断与治疗。然而，绝大多数病例最初由正畸医师（orthodontist）确诊，这是由于正畸治疗过程中会开展标准化影像记录，可提供充足的影像学检查条件。在颈部外吸收的诱因中，临床常误将其归因于正畸治疗、创伤性咬合乃至慢性炎症性牙周病。本文所述的多种场景均证实，外宫颈型牙体吸收与牙外伤存在密切关联。在既往乃至部分当代病例中，该病可能由牙内漂白诱发，但目前牙髓治疗后患牙的牙内漂白操作已日趋少见。针对外宫颈型牙体吸收的临床病例，诊断与治疗阶段需遵循若干操作要点及注意事项。本研究梳理了相关理论基础，可辅助临床医师针对每一例具体病例安全且精准地开展诊疗工作。其中部分要点与注意事项与正畸诊疗相关。