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Extra canal invasive resorption - Case 2 Case 1

The opinions and photographs within this web page are not ours. Authors have been credited
for the individual posts where they are. - Photos courtesy of Yosef Nahmias -
From: Yosef Nahmias
Sent: Tuesday, April 24, 2001 1:25 PM

Please look at this case!

Patient was referred to me for assessment of tooth #41 (FDI). 
He is 27 years old.No symptoms at all. No history of trauma 
(although he plays hockey!). Had extensive ortho done some 
time ago! Medical OK!  Distal Buccal pocketing 4 mm. Bleeding 
upon probing. Tooth appears to be testing vital 
(cold and Vitalometer!). No palpation, mobility and no 
percussion sensitivity!

So now WHAT?

You know guys, it is incredible. One of you mentions that 
they saw a broken instrument, next day I get one! Next day, 
someone talks about a perforation, next day, I get one. 
Is like the bad spirits are against me!


Photos courtesy of Yosef Nahmias -
From: John J. Stropko, D.D.S. Sent: Wednesday, April 25, 2001 9:23 PM Yosi, Looks like a classic radiographic appearance of Extra-Canal Invasive Resorption. Get together with the top perio guy in your area and discuss. I am guessing that you will lose the tooth in spite of all attempts. Heard a talk by some "flakey" periodontist Dr Eric Rindler)----just kidding Rick ---he was great!---last night at our local study club meetingt He also is seeing more of this. A Dr Heathersay (sp?) from Australia is supposedly THE expert on this. Any other ideas? John Stropko From: PBery Sent: Wednesday, April 25, 2001 10:25 AM Invasive cervical resorption. Tx: eventual extraction, as proper restoration will be tough! Otherwise, if judged restorable, endo, cleaning of lesion w. trichloroacetic acid, MTA or bonding, and prayers galore. From: Fred Barnett Sent: Wednesday, April 25, 2001 3:59 PM I have a crazy idea for this type of resorption: how about flap surgery, debridement of defects, EMDOGAIN, resorbable membrane, flap replacement. I thought Emdogain wasnt very predictable, no? - Jerry Avillion From: Uziel Blumenkranz Sent: Thursday, April 26, 2001 6:17 AM Dear Yosi: If that is not an oblique crwon root fracture it is a scaratch in your digital x ray? Invasive cervical resorption, possibly post ortho. I saw some arrested cases shown by Gerald Harrington, and I have a couple of cases that seemed to have healed, however, how much are you willing to gamble? Use Hiethersay's technique now that the resorption has not advanced too much unless you can get some previous X rays. let me know what happens. - Uzi Yosef Nahmias wrote: Thank you guys for the quick response! This case just showed me AGAIN how important it is to be part of this group!! THANKS A MILLION!
K 3 lightspeed

Crown replacement

Root reinforcement

Vertical root fracture

Periodontal pocket

Cox crapification

Cold sensitivity

Buccal sinus

Nikon 995

Distal canals

Second mesial canal

Narrow escape


Severe curvatures

Unusual resorption

Huge pulpstone

Molar access

Perforation repair

Maxillary molars

Protaper shaping

Pulsing pain

Apical periodontitis

Mesial middle

Isthmus protocol

Fragment beyond apex

Apical trifurcation

Jammed K file

Mesial canals

Irreversible pulpitis

Bicuspid abscess

Sideways molar

Red Dye allergy

Small mirrors

Calcified molar

Extraction and implants

Calcificated central

Internal resorption

Bone lucency

Porcelain inlay

Bone allograft