Root Resorption Flashcards
what is the definition of root resorption
non-bacterial destruction of dental hard and soft tissue due to the interaction of clastic cells
what are the key features of the clastic cells
very motile
ruffled border
in contact with dentine
what stimulates resorption
RANKL
what stimulates RANKL for resorption
parathyroid hormone
bacterial lipopolysaccharides
trauma
chronic inflammation
what does RANKL do
promote development
what does OPG do
inhibit RANKL and development
what are the surfaces of the root acting to prevent resorption
periodontal ligament
cementum
predentine
what are the main classifications of root resorption
internal and external
what are the types of internal root resorption
inflammatory
replacement
what are the types of external root resorption
inflammatory
replacement
cervical
surface
what do we look for when examining the coronal integrity of remaining tooth
if it can be restored after treatment
what do we look for when looking at the colour of the tooth
pink spots
why do we look for pocketing when examining a tooth
to see if there is periodontal communication with the resorption
what would a sinus in the mucogingival junction indicate
internal resorption has perforated the root canal
what are swelling and apical tenderness associated with
periradicular disease
what radiographs do we need when assessing resorption
2 angles for parallax
or CBCT
what are the notable clinical findings for internal inflammatory resorption
everything is normal with positive sensitivity testing
what is seen on radiographs with internal inflammatory resorption
parallel canals lost
radiolucency in canal does not move with beam shift
what is the pathogenesis of internal inflammatory resorption
coronal pulp necrotic
inflammatory and vascular tissue in lesion
apical pulp vital to power progression of resorption
how do you treat internal inflammatory resorption
endodontics only
what are the notable clinical findings with internal replacement resorption
everything is normal with positive sensitivity testing
what are the radiographic findings with internal replacement resorption
mineralised tissue within the canal forming trabecular shape
what is the treatment for internal replacement resorption
need to wait until symptomatic to take it out as cant get files through the mineralised tissue
what are the notable findings for external surface resorption
increased physiological mobility
positive sensitivity
what are the radiographic findings for external surface resorption
very short resorbed roots
PDL intact
sometimes radiolucency from ectopic tooth
what is the aetiology for external surface resorption
ectopic teeth
pathological lesions
idiopathic
what is the treatment for external surface resorption
remove the source
splint if mobile
what are the notable clinical findings for external inflammatory resorption
possible sinus/swelling/apical tenderness/percussion
sometimes increased mobility
negative to sensitivity (necrotic pulp)
what is seen radiographically with external inflammatory resorption
large periapical radiolucencies
roots resorbed from apex upwards
what is the aetiology of external inflammatory resorption
necrotic pulp
periapical inflammatory lesion precipitates resorption process
how do you treat external inflammatory resorption
remove cause of inflammation
orthograde endodontic treatment
possibly surgical endodontics
extraction
what are the notable findings from external replacement resorption
infra occluded
high pitched note
no physiological mobility
positive sensitivity
what can be seen radiographically for external replacement resorption
no PDL
what is the aetiology for external replacement resorption
trauma (avulsion or lateral luxation)
when would you decoronate for replacement resorption
if infraocclusion more than 1mm in growing patient
why would you choose to decoronate
to preserve bone volume
what are the treatment options for external replacement resorption
decoronation
monitor
add composite incisally to lengthen tooth
what are the notable clinical findings for external cervical resorption
pocketing with profuse BOP
pink spot
positive sensitivity
what can be seen radiographically with external cervical resorption
radiolucency in the canal which moves when you look at it from another angle
what protects the pulp from external cervical resorption
predentine
what are the risk factors for developing external cervical resorption
orthodontics
trauma
historical non-vital whitening with heat
wind instruments
viral infection
systemic disturbance
what are the treatment options for external cervical resorption
monitor - continued resorption
extract
internal repair and endodontics
what types of resorption use orthograde endodontics as treatment options
external inflammatory
internal inflammatory
what types of resorption use surgical endodontics as treatment option
external cervical
what treatments do not use endodontics at all for treatment
external replacement
external surface
