Surgical-restorative treatment of bleaching-related external root resorption

Three teeth in 2 patients were treated after intracoronal bleaching with 30% hydrogen peroxide had resulted in external root resorption. An attempt to treat one tooth by placing an intracoronal dressing with calcium hydroxide had failed. The resorption defects were exposed surgically by reducing and re-contouring the alveolar crest. The restorations were made during the surgical procedure, with a light-cured composite in one case and with amalgam in the other, and were of compromised quality due to the difficulty of control. One year follow-up examinations revealed periodontal complications in both cases, in the form of a further resorption of the alveolar crest and gingival edema. These sequelae suggested that the restoration of bleaching-related resorption defects should have been a secondary stage, after the surgical exposure of the defects had been completed first. For the purpose of exposing the defects, the level of the alveolar crest should be reduced enough to secure a biological width from the restorations.