Root resorption Flashcards
What is the definition of root resorption?
Non-bacterial destruction (body doing it to itself) of the dental hard and soft tissue due to the interaction of clastic cells
What are key features of osteoclasts that resorb dentine (dentinoclasts)?
Very motile
Ruffled border
In contact with dentine
What is the relationship between RANKL and OPG?
RANKL upregulates osteoclasts
OPG downregulates osteoclasts
If relationship between RANKL and OPG is changed bone deposition is either increased or decreased.
What 4 things stimulate RANKL?
Parathyroid hormone B3 and IL-1B
Bacterial lipopolysaccharides
Trauma (physical, chemical)
Chronic inflammation
What are the 2 types of internal root resorption?
Inflammatory
Replacement
What are the 4 types of external root resorption?
Inflammatory
Replacement
Cervical
Surface
What is the main thing to look for radiographically to determine whether resorption is internal or external?
If parallel lines of root canal are lost - most likely internal resorption
If tram lines are still apparent then most likely external resorption - external un-related to the root canal
If you see a shift in what you are looking at from parallax is it likely to be internal or external resorption?
External resorption
What are the primary treatment strategies for external and internal inflammatory resorption?
Orthograde endo
What is the primary treatment strategies for external cervical resorption?
Surgical endo
What is the aetiology of internal inflammatory resorption?
Necrotic coronal pulp
Lesion includes inflammatory and vascular tissue
Apical pulp vital
Lesion continues to progress until apical pulp goes necrotic - infection exits through apex
What is the main cause of external surface resorption?
Orthodontics
What is of high concern for patients with external surface resorption?
Perio - much less supporting root structure - increased risk of quicker tooth loss
Aetiology of external inflammatory resorption?
Necrotic pulp - bacterial/ dental trauma origin
PA inflammatory lesion precipitates the resorption process
Aetiology of external replacement?
Ankylosis of tooth - generally caused by trauma - most likely lateral luxation or avulsion
