when is extraction versus restorative treatment indicated for feline tooth resorption lesions?

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Extraction is the gold standard treatment for feline tooth resorption (TR) in all cases where the crown is affected, and the choice between full extraction and crown amputation with intentional root retention is determined entirely by radiographic findings. No restorative treatment is indicated for any stage of feline TR — there is no known treatment that prevents development or progression of the lesion, and restoration is not a recognized option.1 Full extraction is indicated when the periodontal ligament space is radiographically visible, meaning the root retains its structural integrity and the ligament has not been replaced by bone.2 In these cases, the root can be luxated and elevated conventionally, though teeth with resorptive lesions are notoriously difficult to extract due to structural compromise.1 Crown amputation with intentional root retention is indicated when severe external replacement resorption is present radiographically — that is, when the periodontal ligament space is absent and the root has been replaced by bone-like tissue, making complete extraction technically complex and excessively traumatic.2 This approach is explicitly contraindicated if apical periodontitis is present, regardless of the radiographic appearance of the root.2 It is acceptable to leave a tooth untreated when resorption is limited entirely to the root with no crown involvement, provided the patient shows no signs of oral discomfort.2 This applies to lesions that are radiographically detectable but clinically silent at the crown level. TR staging (TR1–TR5) guides the urgency of intervention. TR1 represents mild dental hard tissue loss, TR2 moderate, TR3 deep, TR4 extensive, and TR5 describes remnants of dental hard tissue with complete gingival covering.7 Radiography is required to assign both stage and type, as clinical and tactile examination detects only late-stage lesions when they become evident in the crown.18 Radiographic examination is non-negotiable for every treat