Root Resorption

Question 1

What is root root resorption?

Answer 1

This is the non bacterial destruction of dental hard and soft tissues due to activity of clastic cells (osteoclasts, dentoclasts)

Question 2

What acts to prevent resorption in teeth?

Answer 2

PDL
cementum
Pre dentine

however as soon as clastic cells (multinucleate giant cells) come into contact with dentine resorption occurs

Question 3

How does root resorption occur?

Answer 3

Due to imbalance of OPG and RANK-L - balance tips towards RANK-L which binds to RANK and causes upregilation of osteoclasts which stimulates the breakdown of bone

OPD down regulates osteoclast activity and promotes bone deposition

Question 4

What are the types of resorption?

Answer 4

INTERNAL (RI)

EXTERNAL (RISC)

Question 5

What are the types of internal resorption?

Answer 5

Internal Inflammatory

Internal Replacement

Question 6

What are the types of external resorption?

Answer 6

Replacement

Inflammatory

Surface

Cervical

Question 7

What is internal resorption?

Answer 7

This is where resorption occurs within the root canal aspect of the canal and it balloons out - there is loss of the tram lines of the canal

Question 8

What is external resorption?

Answer 8

This is where resorption occurs outwit the root canal space and it is superimposed over the Canal - tram lines remain in position

Question 9

How can we determine if its external or internal resorption?

Answer 9

PARALLAX - if resorption moves position then its external

Question 10

Describe internal inflammatory resorption

Answer 10

This is where resorption occurs within pulp canal space and there is progressive loss of dentine - it is a pathological process where giant cells nibble away at the tooth - the coronal aspect is non vital but area below the resorption lesion will be vital - the lesion continues until all aspect of pulp is necrotic then stops progressing

Internal inflammatory resorption involves progressive loss of dentin

Question 11

What is the tx for internal inflammatory resorption?

Answer 11

Orthograde RCT as the pulp is inflamed

Question 12

What is the risks of RCT on teeth with internal inflammatory resorption?

Answer 12

Risk of haemorrhage in the Canal

use inter canal medicament

Question 13

What is internal replacement resorption?

Answer 13

This is where there is internal resorption that results in deposition of dentine, cemetum and bone within in the pulp chamber - it becomes radiopaque

the pulp becomes large and root canal system expands

Question 14

What is tx for internal replacement resorption?

Answer 14

Accept and monitor

RCT carries too many risk due to change occurring in root canal system

Question 15

What is external inflammatory resorption?

Answer 15

This is where there is loss of cementum due to damage to the external surface of the tooth root during trauma, plus the root canal system has become infected with bacteria. It is characterized by the radiographic appearance of loss of tooth substance with a radiolucency in the adjacent periodontal ligament and bone.

the tooth is necrotic and heavily restored and inflammation occurs which can be bacterial or due to trauma and then PA inflammatory lesions starts which is followed by resorption

NEGATIVE SENSIBILIT
USUALLY RESTORED

Question 16

What is the tx for external inflammatory resorption?

Answer 16

the pulp is necrotic and apex is inflamed - need to carry out RCT or XLA

Question 17

What is external replacement resorption?

Answer 17

Known as ankylosis in pads

this is where TRAUMA either AVULSION OR LATERAL LUXATION results in ostoelcasts being in direct contact with external root dentine and resorption occurs

May see GP ending up in bone

Question 18

What is tx for external replacement respiration?

Answer 18

RCT wont stop progression but need to extirpate within 7-10 days and RCT but can use non setting calcium hydroxide rather than obdurating

Question 19

What is external surface resorption?

Answer 19

This is where there is increased mobility and the roots get shorter in length but the PDl is intact and no PA lucency - often due to ortho, idiopathic, ectopic teeth, pathological lesions

Question 20

What is tx for external surface respiration?

Answer 20

No RCT as pulp is vital and healthy

need to remove cause - braces, ectopic tooth

Question 21

What is external cervical resorption?

Answer 21

loss of cementum due to damage to the external surface of the tooth root during trauma, plus the root canal system has become infected with bacteria. It is characterized by the radiographic appearance of loss of tooth substance with a radiolucency in the adjacent periodontal ligament and bone.

The external surface of the root is surrounded by a protective layer called precementum. Damage to this layer allows resorptive cells (odontoclasts) to penetrate the root.

Question 22

Signs of external cervical resoprtion?

Answer 22

Pink spot
sungivibal cavity
apple core radiograph

Question 23

What causes external cervical resorption?

Answer 23

Trauma
ortho

Question 24

What is tx of external cervical resorption?

Answer 24

Often xla and replace