Invasive cervical root resorption in a cancer patient: A rare case report with 2 years of follow-up and literature review

Introduction: Cases involving invasive cervical root resorption (ICRR) in oncological patients are rare, in addition, follow-up of these patients has not yet been reported in the literature.

Objective: This study aims to present a literature review and report a case of denosumab as a possible cause of ICRR in a patient with breast cancer with 2 years of follow-up.

Case report: A 39-year-old female with a history of luminal breast cancer was treated with denosumab semiannually for osteopenia with discontinuation 1 year ago. Oral examination revealed areas of ICRR lesions on two mandibular teeth. The patient presented irreversible pulpitis on the lower left first molar (#19). The lower right first premolar (#28) was asymptomatic, and the resorption cavity was restricted to the tooth crown. Cone-beam computed tomography (CBCT) established the ICRR 2Bp and 2Ad diagnosis in teeth #19 and #28, respectively. Periodontal surgery and a nonsurgical root canal were performed in the molar and restorative treatment was performed in the premolar. Two years after treatment, both teeth were functional and asymptomatic, and probing was within normal limits (< 3 mm) without bleeding. Periapical radiographic examination revealed no progression of resorption nor new lesions.

Conclusions: This article highlights a rare adverse effect of an antiresorptive therapy, unfamiliar to most clinicians and specialists. In addition, it emphasizes that the early diagnosis and follow-up of ICRR are relevant and can provide successful treatment, avoiding infections and extractions.