Root Resorption Flashcards

1
Q

what is the definition of root resorption

A

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

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2
Q

what are the key features of the clastic cells

A

very motile
ruffled border
in contact with dentine

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3
Q

what stimulates resorption

A

RANKL

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4
Q

what stimulates RANKL for resorption

A

parathyroid hormone
bacterial lipopolysaccharides
trauma
chronic inflammation

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5
Q

what does RANKL do

A

promote development

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6
Q

what does OPG do

A

inhibit RANKL and development

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7
Q

what are the surfaces of the root acting to prevent resorption

A

periodontal ligament
cementum
predentine

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8
Q

what are the main classifications of root resorption

A

internal and external

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9
Q

what are the types of internal root resorption

A

inflammatory
replacement

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10
Q

what are the types of external root resorption

A

inflammatory
replacement
cervical
surface

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11
Q

what do we look for when examining the coronal integrity of remaining tooth

A

if it can be restored after treatment

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12
Q

what do we look for when looking at the colour of the tooth

A

pink spots

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13
Q

why do we look for pocketing when examining a tooth

A

to see if there is periodontal communication with the resorption

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14
Q

what would a sinus in the mucogingival junction indicate

A

internal resorption has perforated the root canal

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15
Q

what are swelling and apical tenderness associated with

A

periradicular disease

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16
Q

what radiographs do we need when assessing resorption

A

2 angles for parallax
or CBCT

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17
Q

what are the notable clinical findings for internal inflammatory resorption

A

everything is normal with positive sensitivity testing

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18
Q

what is seen on radiographs with internal inflammatory resorption

A

parallel canals lost
radiolucency in canal does not move with beam shift

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19
Q

what is the pathogenesis of internal inflammatory resorption

A

coronal pulp necrotic
inflammatory and vascular tissue in lesion
apical pulp vital to power progression of resorption

20
Q

how do you treat internal inflammatory resorption

A

endodontics only

21
Q

what are the notable clinical findings with internal replacement resorption

A

everything is normal with positive sensitivity testing

22
Q

what are the radiographic findings with internal replacement resorption

A

mineralised tissue within the canal forming trabecular shape

23
Q

what is the treatment for internal replacement resorption

A

need to wait until symptomatic to take it out as cant get files through the mineralised tissue

24
Q

what are the notable findings for external surface resorption

A

increased physiological mobility
positive sensitivity

25
Q

what are the radiographic findings for external surface resorption

A

very short resorbed roots
PDL intact
sometimes radiolucency from ectopic tooth

26
Q

what is the aetiology for external surface resorption

A

ectopic teeth
pathological lesions
idiopathic

27
Q

what is the treatment for external surface resorption

A

remove the source
splint if mobile

28
Q

what are the notable clinical findings for external inflammatory resorption

A

possible sinus/swelling/apical tenderness/percussion
sometimes increased mobility
negative to sensitivity (necrotic pulp)

29
Q

what is seen radiographically with external inflammatory resorption

A

large periapical radiolucencies
roots resorbed from apex upwards

30
Q

what is the aetiology of external inflammatory resorption

A

necrotic pulp
periapical inflammatory lesion precipitates resorption process

31
Q

how do you treat external inflammatory resorption

A

remove cause of inflammation
orthograde endodontic treatment
possibly surgical endodontics
extraction

32
Q

what are the notable findings from external replacement resorption

A

infra occluded
high pitched note
no physiological mobility
positive sensitivity

33
Q

what can be seen radiographically for external replacement resorption

A

no PDL

34
Q

what is the aetiology for external replacement resorption

A

trauma (avulsion or lateral luxation)

35
Q

when would you decoronate for replacement resorption

A

if infraocclusion more than 1mm in growing patient

36
Q

why would you choose to decoronate

A

to preserve bone volume

37
Q

what are the treatment options for external replacement resorption

A

decoronation
monitor
add composite incisally to lengthen tooth

38
Q

what are the notable clinical findings for external cervical resorption

A

pocketing with profuse BOP
pink spot
positive sensitivity

39
Q

what can be seen radiographically with external cervical resorption

A

radiolucency in the canal which moves when you look at it from another angle

40
Q

what protects the pulp from external cervical resorption

A

predentine

41
Q

what are the risk factors for developing external cervical resorption

A

orthodontics
trauma
historical non-vital whitening with heat
wind instruments
viral infection
systemic disturbance

42
Q

what are the treatment options for external cervical resorption

A

monitor - continued resorption
extract
internal repair and endodontics

43
Q

what types of resorption use orthograde endodontics as treatment options

A

external inflammatory
internal inflammatory

44
Q

what types of resorption use surgical endodontics as treatment option

A

external cervical

45
Q

what treatments do not use endodontics at all for treatment

A

external replacement
external surface