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External Cervical Resorption: A Volumetric Analysis on Evolution of Defects over Time.

Ali Nosrat¹, Omid Dianat¹, Prashant Verma²

¹Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland; Private Practice, Centreville Endodontics, Centreville, Virginia.

Journal of Endodontics

|November 3, 2022

Summary

Untreated external cervical resorption (ECR) defects significantly increase in volume and develop more root perforations over time. ECR is dynamic, with volumetric growth not being uniform.

Keywords:

Cone-beam computed tomography external cervical resorption invasive cervical root resorption perforation segmentation volumetric quantification

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Area of Science:

Dentistry
Oral Pathology
Radiology

Background:

External cervical resorption (ECR) is a pathological process affecting teeth.
Understanding the progression of ECR is crucial for patient management.
Volumetric quantification offers a precise method to assess ECR defect changes.

Purpose of the Study:

To evaluate the temporal changes in external cervical resorption (ECR) defects.
To quantify ECR defect volume evolution using cone-beam computed tomography (CBCT).
To analyze the development of root surface perforations in untreated ECR.

Main Methods:

CBCT scans of patients with untreated ECR were analyzed at baseline and recall.
ECR defects were segmented and their volumes quantified.
Three-dimensional defect classification and perforation prevalence were assessed; statistical analysis included Wilcoxon, chi-square, and regression models.

Main Results:

Fifteen patients (20 teeth) with a mean recall of 21 months were studied.
ECR defect volume and the defect-to-tooth volume ratio significantly increased over time (P=.0001).
Root surface perforations (≥1 mm) increased from 45% at baseline to 85% at recall (P=.008).

Conclusions:

Untreated ECR defects demonstrate significant volumetric increase and progression.
The dynamic nature of ECR involves increased defect size and root perforations.
Volumetric ECR progression is not characterized by uniform or linear expansion.