Abstract:

Background: External cervical resorption (ECR) with pulpal involvement poses a significant therapeutic
challenge due to its asymptomatic progression, complex defect morphology, and risk of structural
compromise. Conservative treatment approaches, combining endodontic and restorative protocols, have
emerged as viable alternatives to extraction or extensive surgery, particularly with the advent of bioactive
materials such as mineral trioxide aggregate (MTA) and calcium silicate-based cements.
Aim: This study aimed to evaluate the five-year clinical outcomes of conservative treatment in 35
consecutively managed cases of ECR with pulpal involvement.
Methods: All cases were treated using standardised protocols consisting of endodontic therapy, when
indicated, and defect restoration with bioactive restorative materials. Clinical and radiographic follow-up was
conducted at 6 months, 12 months, and annually thereafter, assessing tooth survival, periodontal health,
functional stability, and potential complications.
Results: The five-year follow-up demonstrated a high overall survival rate, with the majority of cases
maintaining function and stability. Most restorations remained intact and asymptomatic, while complications
were limited to isolated restorative and endodontic issues that were successfully managed. No cases exhibited
progressive resorption beyond the treated margins.
Conclusion: Conservative management of ECR with pulpal involvement can provide predictable long-term
outcomes, offering clinicians a biologically sound, minimally invasive strategy for tooth preservation. These
findings reinforce the role of bioactive materials and careful case selection in achieving favourable results and
support conservative treatment as a reliable option in clinical practice.
Keywords: external cervical resorption, pulpal involvement, conservative treatment, bioactive materials,
long-term outcomes