IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 1 Ver. IX (January. 2017), PP 24-32 www.iosrjournals.org DOI: 10.9790/0853-1601092432 www.iosrjournals.org 24 | Page Invasive Cervical Resorption: An Insidious Form of External Tooth Resorption Dr. P.V. Samir 1 , Dr. Kanika Singh Dhull 2 , Dr. Brahmananda Dutta 3 , Dr. Anandamoy Bagchi 4 , Dr. Tulika Verma 5 Kalinga Institute of Dental Sciences, Bhubaneswar Abstract: Invasive cervical resorption (ICR) is an unusual form of external root resorption which initiates below the epithelial attachment and coronal aspect of supporting alveolar process to be precise zone of connective tissue attachment. It has an unclear etiology leading to its non diagnosis or misdiagnosis as a pink tooth (internal resorption). Dr. Geoffrey Heithersay contributed immensely in diagnosis and clinical classification of ICR into 4 stages based on its clinical, pathological and radiological finding and potential pre-disposing factors. These lesions can be treated by either non surgical or surgical intervention depending upon the access of the lesion or its progress towards pulp. Management of lesions of ICR should be treated with a primary objectives of i) Inactivation of all resorbing tissues and ii) Reconstruction or resorptive tooth defect by an ideal restorative material or biological systems. Earlier is the diagnosis more successful is the outcome of management of invasive cervical resorption. This article reviews on diagnosis of ICR, correlating it with its clinical, radiological and histo-pathological findings along with management in brief. Keywords: Cervical resorption, External resorption, Invasive lesion, Tooth resorption I. Introduction Tooth resorption is described as loss of hard dental tissues like cementum and dentin due to odontoclastic activity. Root resorption is the most common form of tooth resorption which arises as a late complication following any luxation injuries. Root resorption based upon their location can be classified as External root resorption (Root surface resorption) and Internal root resorption (Root canal resorption). External resorption can be physiological or pathological. The pathological forms of external root resorption can be classified into 5 forms: external surface resorption, external inflammatory root resorption, external replacement resorption (ankylosis), external cervical resorption and transient apical breakdown. External cervical resorption is also known as Invasive cervical resorption: an aggressive, subtle and rare form of external tooth resorption of any permanent tooth. 1 Invasive cervical resorption (ICR) is defined as a localised resorptive process that involves the surface of root below epithelial and coronal aspect of supporting alveolar process namely the zone of connective tissue attachment. 2 It can be characterised by its invasive nature and cervical location leading to progressive and destructive loss of tooth structure. The affected tooth`s crown shows pinkish discoloration due to enamel and coronal dentin resorption and its replacement with highly vascular tissue. 3 Similar resorptive processes are seen in different other locations such as Invasive coronal resorption: enamel defect in the crown of erupting tooth and Invasive radicular resorption: resorption involving more apical source. Mueller & Rony in 1930 first described the condition of idiopathic cervical resorption. Term invasive cervical resorption was first coined by Dr. Geoffrey Heithersay. Invasive cervical resorption continues to be misdiagnosed as internal resorption till date due to pink spot lesion of internal resorption described by Gaskill (1894) and Mummery (1920). 4,5 Researchers and clinicians over the years have labelled this Invasive cervical resorption in various other forms like: odontoclastoma, idiopathic external resorption, peripheral cervical resorption, cervical external resorption, extracanal invasive resorption, supraosseous extracanal invasive resorption, peripheral inflammatory root resorption, cervical resorption, subepithelial inflammatory root resorption, burrowing resorption, late cervical resorption, periodontal infection resorption, fibrous dysplasia of teeth. 6 II. Etiology ICR is a rare, insidious and aggressive form of tooth resorption with idiopathic etiology. Literature is still biased on the resorptive process in ICR which may result either from sulcular microorganisms activating pure inflammation or by benign proliferative fibroosseous / fibrovascular disorder where microorganisms have no role but are secondary invaders. This dilemma in literature signifies idiopathic etiology of ICR. Based upon etiology of external resorption it may be classified into (1) Trauma induced tooth resorption (2) Infection