Bone and cementum‐like tissue eventually replace all or part of the periodontal ligament, dentin, and pulp in teeth with Type 2 resorption. Although complete extraction is the generally accepted treatment for resorption, intentional crown amputation with gingival closure can be effective for cases of Stage 2 to 5 with moderate to advanced Type 2 resorptions or Type 2 resorptions exposed to the oral cavity (ie, external noninflammatory replacement resorption).
Crown amputation with gingival closure is an advanced dental procedure involving creation of a mucogingival flap; use of a water-cooled, high-speed delivery system; and closure without tension that should only be performed after intraoral radiography confirms complete root extraction is not possible based on marked decrease in root opacity and absence of periodontal ligament space. The resorption is sealed off from the oral cavity, and the root continues being replaced by bone.
In teeth affected by Type 3 resorption, roots affected by Type 2 resorption can be treated with crown amputation; the remaining roots should be extracted. Crown amputation typically results in subjectively less trauma and faster healing compared with complete extraction.2
Contraindications for crown amputation with intentional partial root retention include periodontal disease evidenced by horizontal or vertical bone loss, endodontic disease, radiographic presence of a root canal, and chronic gingivostomatitis. Crown amputation should not be performed if intraoral dental radiography is not possible.