Root Resorption Flashcards

1
Q

What is the definition of root resorption?

A

The non bacterial destruction of the dental hard and soft tissue due to the interaction of clastic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the key features of osteoclast cells involved in root resorption?

A
  • very motile
  • ruffled boarder
  • in contact with dentine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can cause RANKL stimulation?

A
  • parathyroid hormone, B3 and interleukin-1b
  • bacterial lipopolysaccharides
  • trauma (physical, chemical)
  • chronic inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What surfaces are involved in preventing the process of root resorption?

A
  1. PDL (protective element against osteoclasts)
  2. Cementum (particularly the non-mineralised layer)
  3. Predentine (non collagenous component that lies close to pulp)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How can root resorption be classified?

A

Internal and External resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What types of internal root resorption exist?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you examine root resorption on a radiograph?

A

Need 2 angles
- 30 degrees mesial or distal beam shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you tell the difference between internal and external root resorption on a radiograph?

A

Internal
- lose the parallel lines of the root canal system
- root canal system appears wider on radiograph

External
- nothing to do with root canal system
- parallel lines still present
- diffuse radiopacities present over root but parallel lines still present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the pathogenesis of internal inflammatory root resorption?

A
  • coronal pulp is necrotic
  • lesion includes inflammatory and vascular tissue (if perforated will communicate with PDL)
  • apical pulp is vital (important as this blood supply drives resorption)
  • lesion will continue to progress until apical pulp goes completely necrotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What treatment option is avail able for internal root resorption?

A

Orthograde endodontics ONLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What types of internal root resorption exist?

A
  • inflammatory
  • replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of root resorption is this?

A

Internal replacement resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What types of external root resorption exist?

A
  • surface
  • inflammatory
  • cervical
  • replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the PDL appear in external root surface resorption?

A

PDL normal and intact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the common aetiology of external surface root resorption?

A

Orthodontics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is seen on this PA radiograph?

A

Root resorption of CI root due to ectopic canine
(trabecular pattern suggests its filled in with bone after canine moved away, therefor no treatment)

17
Q

What are the different causes of External Root Surface Resorption?

A
  • orthodontics
  • ectopic teeth (eg pressure on roots from these teeth)
  • pathological lesions
  • idiopathic
18
Q

What is the treatment option for external root surface resorption?

A

DO NOT DO ENDO (has nothing to do with the resorption)

REMOVE THE SOURCE (eg ectopic tooth / orthodontal brackets)

19
Q

What can you see on this PA radiograph?

A
  • close proximity of restoration to pulp
  • large PA radiolucency
  • external inflammatory root resorption
20
Q

What is the aetiology of external inflammatory root resorption?

A

Necrotic pulp (bacterial or dental trauma in origin)
- PA inflammatory lesion precipitates the resorption process

21
Q

What is the treatment option for external inflammatory root resorption?

A

Remove the cause of inflammation
- orthograde endodontic (re) treatment
- possibly surgical endodontics or XLA

22
Q

What happens if you percuss a tooth with external replacement root resorption?

A

High pitched note

23
Q

How does external replacement root resorption present on a radiograph?

A

NO obvious periodontal ligament
- root canal system normal
- PA area normal

24
Q

What is the aetiology of external replacement root resorption? Explain how it works.

A

Trauma (significant injury to periodontium such that bone and osteoclasts are then in contact with external root dentine and resorption begins)

25
If external replacement resorption occurs in a GROWING patient, what is seen?
Infraocclusion of tooth because it becomes fused to bone.
26
What must you do in patients that are still growing that have external replacement root resorption?
Decoronation to allow bone and periodontium to grown around - then replace space once stopped growing
27
How does external cervical root resorption present clinically?
pink spot colour (haemorrhages if probed)
28
How does external cervical root resorption present on radiographs?
- "apple core" presentation - Parallel root canal system lines still present
29
What protects the pulp from external cervical root resorption destroying the pulp/root canal system?
Predentine
30
What are some risks for development of external cervical root resorption?
- orthodontics - trauma - viral infections - non vital whitening when heat applied
31
What treatment options are available for external cervical root resorption?
- nothing & monitor - XLA and prosthetic replacement - internal repair and orthograde endodontics
32