Advanced external resorption can be treated successfully through and internal approach

Patient: 55 year old male with controlled hypertension

Chief Complaint: Asymptomatic

Dental History: Previous endodontic therapy was performed in 2002 by an endodontist after which a porcelain fused to metal crown was placed (tooth #19).. A coincidental routine periapical radiograph showing a large mid-root radiolucency prompted referral to the author.

Significant Findings: The patient presented with normal responses to all tests except bleeding upon probing at the mid-mesial, mesiobuccal, and mesiolingual line angle areas. The probing depths were within normal limits. Conventional radiographic and CBCT exams revealed a significant mid-root radiolucency of the distal root consistent with external inflammatory resorption. There was no evidence of endodontic pathosis or flow of the root canal filling material into the defect area so it was presumed to be resorption having developed after 2002.