Management of resorption

Question 0

How should trauma induced pressure resorption be managed?

Answer 0

Remove cause (neoplasm, unerupted tooth)

Question 1

How should trauma induced surface and transient apical internal resorption be managed clinically?

Answer 1

Monitor radiographically. Endodontic treatment only if signs of infection or ongoing discolouration (for transient apical internal)

Question 2

How should trauma induced orthodontic resorption be managed?

Answer 2

Do nothing. Should sttabilise on completion of ortho treatment.

Question 3

How should trauma induced replacement resorption be managed?

Answer 3

Mature tooth in normal occlusion:
-> leave and monitor for ultimate implant replacement.
-> If in infraocclusion, can surgically reposition and treat tooth with Emdogain.
Immature tooth in infra-occlusion:
1) In selected cases, can surgically reposition and treat tooth surwface with Emdogain
2) Decoronate and submerge
3) Implant therapy, if necessary, with alveolar growth completed

Question 4

How should infection induced internal inflammatory resorption be managed?

Answer 4

Apical:
Endodontic treatment to level of resorption with long term calcium hydroxiide dressing prior to placement of root filling
Intra-radicular:
Endodontic treatment and root canal filling (using a hot GP technique, Obutura)

Question 5

How should infection induced external inflammatory resorption be managed?

Answer 5

Endodontic treatment and intra-canal medication using Ledermix followed by long term CaOH or CaOH alone. Root fill when resorption controlled.
To prevent, following replantation of a mature tooth, pulp extirpation and Ledermix asap.

Question 6

How should a infection induced communicating internal external resorption be controlled?

Answer 6

Endodontic treatment to resorptive defect. Induce calcification by use of CaOH alone or following topical application of 90% trichloracetic acid. ProRoot MTA may also be used.

Question 7

How should hyperplastic internal (invasive) replacement resorption be managed?

Answer 7

Pulpectomy and root filling.

Question 8

How should hyperplastic invasice coronal resorption be managed?

Answer 8

Apply 90% TCA to resorptive tissue after protecting adjacent tissues with glycerol.
Currette TCA affected resorptive tissue from the defect. If theres pulpal invoolvement, pulpectomy and root filling after intra-canal dressing with Ledermix. Orthodontic extrusion if necessary.

Question 9

How should hyperplastic invasive cervical resorption be managed?

Answer 9

Class I and II:
Topical application of 90% TCA, curettage and GIC restoration.
Class III:
Topical application of 90% TCA to resorptive tissue, curettage. Can carry out elective pulpectomy and canal preparation to gain access to deeper and encircling infiltrative channels.
Ledermix paste intra-canal dressing followed by root filling and GIC. ADjunnctive orthodontic extrusion if necessary.
CLass IV:
LEave untreated and monitor or extract and implant.