Root Resorption

Question 1

what is root resorption

Answer 1

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

Question 2

what is RANKL stimulated by
(increase in bone resorption)

Answer 2

parathyroid hormone
bacterial liposaccharides
trauma
chronic inflammation

Question 3

what are the 2 types of internal root resorption

Answer 3

inflammatory
replacement

Question 4

what are the 4 types of external root resorption

Answer 4

inflammatory
replacement
surface
cervical

Question 5

how can internal and external resorption be differentiated on radiographs

Answer 5

internal - loss of parallel lines of root canal system
external - parallel lines still in tact (resorption may be superimposed on top)

external resorption will move during beam shift when doing parallax, internal will not move

Question 6

internal inflammatory RR
- clinical findings
- sensibility test
- treatment

Answer 6

• no obvious clinical findings, incidental finding
• positive response to sensibility tests (at one point pulp is necrotic but vitality fuels resorption, will continue until entire apical pulp is necrotic)
• orthograde endodontics

Question 7

internal replacement root resorption
- incidence
- clinical appearance
- radiographic appearance

Answer 7

• very rare, will probably never see
• no clinical findings, incidental finding
• trabecular looking pulp chamber on x ray

Question 8

external inflammatory RR
- sensibility test
- radiograph presentation
- treatment

Answer 8

• negative sensibility test - pulp is necrotic
• periapical radiolucency and shortened root(s)
• endodontic treatment or extraction

(pulp is necrotic, bacterial or dental trauma in origin, periapical radiolucency precipitates resorption process)

Question 9

External Replacement RR
- clinical findings
- potential cause
- radiograph findings
- treatment

Answer 9

high percussion note, tooth may be infraoccluded
usually due to trauma (avulsion, intrusion, lateral luxation)
radiograph - pulp appears normal parallel lines intact, no periapical radiolucency, no obvious PDL in some/ all regions, root area replaced with bone
- treatment if pt growing - decoronation, if stopped growing, potential composite build ups if infra occluded

Question 10

external cervical root resorption
- clinical findings
- sensibility testing
- radiographic findings
- risk factors
- treatment

Answer 10

• pink spot lesion on crown, profuse BOP in area of resorption
• positive sensibility testing
• parallel lines of root canal system intact, parallax can help determine what surface affected, lesion in coronal portion of root
• orthodontics, trauma, wind instruments
• surgical endodontics and extraction and prosthesis

Question 11

what type of root resorption require surgical endodontics

Answer 11

external cervical

Question 12

what two types of root resorption will endodontic treatment have no impact on

Answer 12

external replacement
external surface

Question 13

external surface RR
- clinical findings
- radiographic findings
- aetiology
- treatment

Answer 13

• normal on examination, possible slight mobility , positive sensibility
• PDL remains intact , parallel lines of root canal system remain, shortened root
• orthodontics, ectopic teeth, pathological lesions, idiopathic
• remove any potential cause e.g orthodontic appliance

Question 14

how can external replacement and external surface resorption be differentiated

Answer 14

external surface the PDL remains intact
in replacement PDL is lost

Question 15

what two types of root resorption is orthograde endodontics a treatment option

Answer 15

external inflammatory
internal inflammatory