The preferred initial treatment for internal resorption is immediate root canal therapy because it removes the inflamed pulp tissue that fuels the resorptive process. Early intervention halts resorption and prevents further structural damage. This approach also allows for proper cleaning, shaping, and obturation of the root canal system. Extraction or surgical options are reserved for advanced or non-manageable cases. Calcium hydroxide dressing alone does not eliminate the underlying pulp pathology, making root canal therapy essential for long-term prognosis.

Reference: Cohen’s Pathways of the Pulp, 12th Edition.