root resorption Flashcards

Question

internal inflammatory resorption - prevalence

Answer 1

can be unrestored no PD pocketing unless lesion has perforated root surface colour and mobility normal no sinus unless PR disease sensitivity testing positive = mostly found incidentally on radiograph

Answer 2

coronal pulp is necrotic lesion includes inflammatory and vascular tissue - if perforated will communicate with PDL apical pulp is vital (need vital pulp to allow it to progress and keep nibbling) lesion will continue to progress until apical pulp goes completely necrotic - until PA radiolucency - indicates complete necrosis - RR likely stopped by this point can happen in any part of root - in apical region a consequence can be root perforation

Answer 3

orthograde endo possible haemorrhage active irrigation and disinfection, internist medicament (disperse and agitate CaOH e.g. endoactivator) - won't be able to mechanically clear all the D of OCs can be hard to find apical canal beyond lesion thermal obturation e.g. warm vertical compaction

Answer 4

no clinical indications | incidental finding radiographically - trabecular pattern in pulp - ossified

Answer 5

``` RCT nearly impossible: - ossified - thin root dentine in walls - perforation risk if can't RCT often let it run course then when symptomatic look at replacement options ```

Answer 6

can be unrestored increased physiological mobility + to sensibility tests

Answer 7

PDL intact | no obvious periapical radiolucency

Answer 8

orthodontics - 90% of teeth have some form of ESR - 2-5% severe ESR - 15% moderate - usually teeth for anchorage are the worst affected ectopic teeth - pressure from erupting tooth pathological lesions - pressure from adjacent pathological lesion e.g. OK idiopathic

Answer 9

pulp healthy - DON'T RCT remove the source to stop the resorption splint if mobile

Answer 10

usually restored no PD pocketing, colour normal may have sinus, swelling, apical tenderness, TTP mobility may be increased depending on extent sensitivity negative - pulp is necrotic

Answer 11

POLL | periapical radiolucency

Answer 12

pulp is necrotic - bacterial or dental trauma in origin periapical inflammatory lesion precipitates the resorption process majority (81%) of teeth with periapical lesions will have microscopic areas of RR - only 7% of these are detectable radiographically

Answer 13

remove the cause of the inflammation usually orthograde endo (re) tx, possibly surgical endo, or extraction if apex significantly resorbed may not be able to control GP - need to alter technique arrests RR only external RR that benefits from endo

Answer 14

``` class 1 class 2 class 3 class 4 ``` ``` 3D imaging apico-coronal direction 1 crestal 2 coronal 1/3 3 middle 1/3 4 apical 1/3 circumferential 1 1/4 2 1/2 3 3/4 4 >3/4 ```

Answer 15

can be unrestored PD pocketing: yes if extensive and profuse BOP - probe may drop into a hard cavity when you probe margin - can misdiagnose as caries - but will be hard to probe pink spot - lesion has good blood supply - don't always see e.g. if small or in particular position may not see it until get to a critical stage normal or no mobility positive to sensitivity testing = won't always have these S and S

Answer 16

radiolucency at level of CEJ can still see parallel RC lines, changes in position with parallax CBCT can show apical coronal spread

Answer 17

``` orthodontics trauma - avulsion and luxation - don't traumatise CEJ with forceps when repositioning traumatised tooth historical non-vital whitening when heat was applied - vvv rare with modern bleaching wind instruments viral infection (from cats) systemic disturbance (thyroid) ```

Answer 18

portal of entry bone-like tissue PRRS: predentine, also called Pericanalar Resorption Resistant Sheet (PRRSP) protects the pulp

Answer 19

``` monitor - the resorption will v likely continue - significant number are progressive extraction and prosthetic replacement surgical repair leave root in situ - preserve ST and bone surgical repair and orthograde endo internal repair and orthograde endo - if can't access surgically ``` need clean and frosted dentine otherwise RR will continue - keep going with chemical disinfection

Answer 20

flap to expose NaOCl - coagulation necrosis can't get rid of all lacunae with handpiece as can't see them and would remove too much tooth

Answer 21

1/3 pulp exposed/after pulp becomes necrotic | do endo first to avoid periapical radiolucency

Answer 22

``` v rarely does it cease and allow healing lesion has a trabecular pattern bone rather than ST the PDL is present no tx ```

Answer 23

``` can be unrestored but infraoccluded - also gingival margin level no PD pocketing, possibly erythematous not TTP but high-pitched note no physiological mobility - ankylosed positive to sensitivity tests ```

Answer 24

loss of obvious PDL cotton wool appearance root surface replaced by trabecular pattern - bone affects a lot of root surface

Answer 25

trauma - significant injuries to there periodontium such that bone (OCs) are then in contact with external root dentine to begin resorption e. g. avulsion or lateral luxation

Answer 26

decoronation | monitor

Answer 27

if infra occlusion is >1mm in a growing pt remove crown to alveolar level and allow root to resorb - root replaced by bone this preserves bone volume adjacent teeth and periodontium develop normally tooth replacement with denture or RBB

Answer 28

alveolus growing around it - need height of bone for implant - also adjacent teeth tip into prosthetic space - MD and vertical problem

Answer 29

if pt has stoped growing endo will not stop resorption - no RCT because of infra occlusion can add composite incisally

Answer 30

external inflammatory | internal inflammatory

Answer 31

external cervical

Answer 32

external surface | external replacement