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Bds4 Perio > Root Resorption > Flashcards

Root Resorption Flashcards

1
Q

What is root resorption?

A

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

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2
Q

What are the 3 key features of the clastic cells which cause root resorption?

A

Very motile
Ruffled border
In contact with dentine

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3
Q

What is the effect of RANKL on the clastic cells?

A

Upregulates resorption

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4
Q

What is the effect of OPG on resorption?

A

Down regulates resorption

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5
Q

What type of cells cause resorption

A

Osteoclasts which, when on root surface, arre referred to as dentinoclasts (multi nucleated giant cells)

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6
Q

What is the function of the ruffled border of clastic cells?

A

Well adapted to resorbing hard tissue

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7
Q

What are risk factors for root resorption?

A

Bacterial endotoxins
Physical trauma (luxation and avulsion)
General chronic inflammation

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8
Q

What are the 3 protective surfaces against root resorption?

A

Periodontal ligament
Cementum
Pre dentine

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9
Q

What are the 6 types of root resorption?

A

Internal inflammatory
Internal replacement

External inflammatory
External replacement
External cervical
External surface

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10
Q

What instrument is used to examine root resorption?

A

PCP12 probe in periodontal pocket to find portal of entry of resorption

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11
Q

What is the difference between internal and external root resorption on radiograph?

A

Internal - ballooning of pulp chamber
External - pulp canal has parallel walls

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12
Q

How does internal inflammatory restoration present with parallax?

A

Doesn’t move with beam shift as in center of canal

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13
Q

What is the pathogenesis of internal inflammatory?

A

Coronal pulp is necrotic, this lesion induces inflammatory and vascular tissue.
Apical pulp is vital
If perforated, will communicate with pdl

Lesion will progress until completely necrotic

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14
Q

What is the treatment for internal inflammatory resorption?

A

Endo treatment
Be aware of possible haemorrhage as part of pulp is still vital. Place Inter visit medicament and use thermal obturation (may not be able to achieve moisture control).

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15
Q

What is the radiographic presentation of internal replacement resorption?

A

Trabecular pattern in enlarged pulp (mineralised tissue).

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16
Q

what is the treatment for internal replacement resorption?

A

Often the patient has no symptoms and RCT is unpredictable so is not likely to benefit the patient.

No active management

17
Q

Why does internal inflammatory resorption have a positive sensibility result?

A

Because part of the pulp is still vital.

18
Q

What are the clinical presentations of external surface resorption?

A

Increased mobility
Positive sensibility

19
Q

What are the radiographic presentations of external surface resorption?

A

PDL intact
Normal pulp
Shortened roots

20
Q

What is the most likely cause of external surface resorption?

A

Orthodontic treatment
Or from ectopic tooth

21
Q

what is the main concern with external surface resorption?

A

Progression of periodontal disease (pt more at risk of losing teeth)

22
Q

What is the treatment for external surface resorption?

A

Deboned ortho/ remove ectopic tooth
Can splint teeth if become mobile
No endo as not from microorganism source (pulp is healthy)

23
Q

What is the clinical presentation of external inflammatory resorption?

A

May have increased mobility
Negative sensibility test as pulp is necrotic
May have swelling/ sinus/ TTP

24
Q

What is the radiographic presentation of external inflammatory resorption?

A

Periapical radiolucency

25
Q

What is the aetiology of external inflammatory resorption?

A

Necrotic pulp (bacterial or dental trauma origin), PA inflammation precipitates resorption.

26
Q

What is the treatment for external inflammatory root resoprtion?

A

Remove the cause of inflammation - endo tx/re endo tx.

27
Q

What are the clinical findings of external replacement resorption?

A

May be infraoccluded
High pitch percussion
No physiological mobility

28
Q

What are the radiographic presentations of external emplacement resorption?

A

Normal pulp
No obvious PDL
Root surface replaced by bone

29
Q

What is the aetiology of external replacement root resorption?

A

Trauma - significant injury to periodontium such that bone (osteoclasts) are then in contact with external root dentine and begin to resorb.
Eg avulsion/ intrusion/ luxation

30
Q

What is the treatment for external replacement resorption?

A

Decoronate the tooth - if infraocclusion >1mm in growing patient. This preserves bone volume for future treatment options.

If pt has stopped growing, monitor. Can add incisal composite

31
Q

What are the clinical features of external cervical resorption?

A

Periodontal pocketing and profuse bleeding
Pink spot
Positive sensibility
Normal or no mobility

32
Q

What are the radiographic findings of external cervical resorption?

A

Apple core effect - radiolucency from portal of entry
Parallel lines of pulp walls still intact - spares the pulp due to presence of pre dentine.

33
Q

What is the role of parallax for external cervical resorption?

A

Can use parallax to identify where the portal of entry is for resorption

34
Q

What is the treatment for external cervical resorption?

A

Internal repair and orthograde endo
Monitor as the resorption will likely continue
Decoronate if extensive as not good prognosis for tooth- save surrounding bone for future treatment options.

35
Q

Which types of resorption would orthograde endo be the primary treatment?

A

External inflammatory
Internal inflammatory

36
Q

Which types of resorption would surgical endo be the primary treatment?

A

External cervical resorption

37
Q

Which types of resorption would endo not be the primary treatment strategy?

A

External replacement and external surface
Internal replacement

Bds4 Perio (5 decks)

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