Multiple external cervical root resorptions after home whitening treatment: a case report

Invasive multiple cervical root resorptions after vital tooth bleaching is a rare condition. The aim of this article is to present a case of multiple external cervical root resorptions (ECRR) after a misguided home whitening treatment. A 34 year old male patient presented with slight sensitivity and mobility in several teeth. Despite the manufacturer's recommendations, the patient used a 22% carbamide peroxide-based tooth bleaching gel at home for 4 days consecutively, at night, on the upper and lower arches. Clinical examination revealed gingival swelling, probing depths ranging 5-7 mm on the buccal and proximal surfaces, and grade 2 mobility of the teeth affected by ECRR. Radiographs revealed presence of ECRR in several teeth during initial examination, and development of multiple new lesions 6 months later. The teeth were subsequently extracted. Histological analysis showed multiple dentine lacunae and areas of dentine reparation. The careful use of these products can prevent sequelae such as those reported in this clinical case. As the vital bleaching has a variable success rate, patients should be informed through a consent form of the benefits and risks of tooth bleaching treatment.