Internal Resorption Treatment — ORE Part 1 MCQ

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ModerateEndodonticsInternal Resorption TreatmentORE Part 1

A 30-year-old patient has a periapical radiograph showing internal root resorption in the coronal third of the root canal of an upper central incisor. The tooth responds positively to sensibility testing. What is the most appropriate management?

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Correct answer: E — Provide root canal treatment

The correct answer is E. Internal root resorption is driven by clastic activity associated with inflamed pulp tissue. Root canal treatment removes the pulpal and granulation tissue that sustains the process and is the established treatment of choice; the resorptive cavity can then be disinfected and obturated appropriately. A positive sensibility response does not justify retaining the pulp when internal resorption is present. Serial review alone risks continued, irreversible loss of dentine. Extraction is not first-line where the tooth is potentially restorable, including many lesions with substantial resorption. External calcium hydroxide does not treat a lesion arising within the canal; calcium hydroxide may be used intracanal as part of endodontic treatment where indicated. A crown may be required later for restoration, but it does not arrest the resorptive process.

Reference: Nilsson E, Bonte E, Bayet F, Lasfargues JJ. Management of internal root resorption on permanent teeth. International Journal of Dentistry. 2013;2013:929486. https://pubmed.ncbi.nlm.nih.gov/24348560/