resorption Flashcards
What are the tooth resorption classifications?
Tooth resorptions are classified by Heithersay (2007) into three broad groups:
1. Trauma Induced Tooth Resorption, with subcat-
egories including:
- Surface Resorption
- Transient Apical Internal Resorption
- Pressure Resorption and Orthodontic Resorption - Replacement Resorption
2. Infection Induced Tooth Resorption, with subcat- egories including:
- Internal Inflammatory (Infective) Root Resorption
- External Inflammatory Root Resorption
- Communicating Internal‐External Inflammatory Resorption
3. Hyperplastic Invasive Resorptions with subcategories including:
- Internal replacement (invasive) resorption
- Invasive Coronal Resorption
- Invasive Cervical Resorption
Root resorptions are classified by Fuss,Tsesis & Lin (2003) into five groups:
1. Pulpal Infection Root Resorption
2. Periodontal Infection Root Resorption
3. Orthodontic Pressure Root Resorption
4. Impacted Tooth or Tumor Pressure Root Resorption
5. Ankylotic Root Resorption
Endodontists are often challenged in particular by
internal root resorption, external inflammatory root resorption, replacement (ankylotic) root resorption, and invasive cervical resorption.
What are the etiology of and treatment for internal root resorption?
Internal root resorption is due to pulp inflam- mation or infection (Andreasen 1985;Tronstad 1988; Bakland 1992). The pulp may go through a dynamic change from pulpitis to necrosis. Pulpectomy is performed when pulp is vital. For necrotic pulp, root canal debridement, calcium hydroxide medication, and root canal filling are the treatments.
What are the etiology of and treatment for external inflammatory and replacement root resorption?
External inflammatory root resorption occurs when pulp becomes necrotic following a traumatic injury.The bacteria and bacterial products in the root canal are the cause and could be exposed to the root surface due to the traumatic damage to cemen- tum (Andreasen 1985; Tronstad 1988; Bakland 1992; Fuss et al. 2003). Inflammatory root resorption is treated by the complete debridement of the root canal and the placement of calcium hydroxide (Tronstad 1988; Heithersay 2007; Komabayashi & Zhu 2012). Root canal filling follows resorption arresting. Replacement resorption may occur due to the death of periodontal ligament cells following replantation of an avulsed tooth.The prognosis is poor. If in a satisfactory position, the tooth can be left in situ and intervention is not needed. In some cases, surgical reposition with root surface Emdogain® treatment may be performed (Filippi, Pohl & von Arx 2006).
What are the classifications of invasive cervical resorption?
The etiology of invasive cervical resorption is largely unknown. Invasive cervical resorption is divided by Heithersay (1999) into four classes:
Class 1: A smaller invasive resorptive lesion near the
cervical area with shallow penetration into
dentine.
Class 2: A well‐defined invasive resorptive lesion
that has penetrated close to the coronal pulp chamber but shows little or no extension into the radicular dentine.
Class 3: A deeper invasion of dentine by resorbing tissue, not only involving the coronal dentine but also extending at least to the coronal third of the root.
Class 4: A large invasive resorptive process that has extended beyond the coronal third of the root.
What are the treatments for invasive cervical resorption?
Non‐surgical treatment for invasive cervical resorption includes topical application of 90% aqueous trichloracetic acid to resorptive tissue, curettage, cavity preparation, and glass ionomer cement or composite resin restoration (Heithersay 1999; Fuss et al. 2003; Heithersay 2007). Surgical treatment includes flap reflection, curettage, 90% aqueous trichloracetic acid application, cavity preparation, and glass ionomer cement or composite resin restoration (Heithersay 1999; Fuss et al. 2003; Heithersay 2007). Pulpectomy is routinely performed for Class 3 resorption. Class 4 resorption has a poor prognosis and may require tooth extraction.
