Root Resorption Flashcards
What is the definition of root resorption?
Root resorption is the non bacterial destruction of the dental hard and soft tissue due to the interaction of clastic cells
What types of internal root resorption are there?
Inflammatory
Replacement
What types of external root resorption are there?
Inflammatory
Replacement
Cervical
Surface
What stages are involved in the stimulation of RANKL?
Parathyroid hormone, B3 and interleukin-1B
Bacterial lipopolysaccharides
Trauma (physical, chemical)
Chronic inflammation
What is the pathogenesis of internal inflammatory?
Coronal pulp is necrotic
Lesion includes inflammatory and vascular tissue- if perforated will communicate with PDL
Apical pulp is vital
Lesion will continue to progress until apical pulp goes completely necrotic
What are the radiographic findings in internal inflammatory?
Resorption is centred in the canal, doesn’t move with a beam shift
What is the treatment of internal inflammatory root resorption?
Orthograde endodontics only
-active irrigation
-intervisit medicament
-thermal obturation
What is changed compared to a normal tooth in external surface resorption?
Increased mobility
What can cause external surface resorption?
Orthodontics
Ectopic teeth- pressure from erupting tooth
Pathological lesions
Idiopathic
How do you treat external surface resorption?
Endodontic treatment will not have any effect
Remove the source to stop the resorption
Splint teeth if mobile
What is different to a normal tooth in external inflammatory resorption?
Possible sinus
Possible swelling
Possible TTP
Mobile
No response to sensibility testing as the pulp is necrotic
What is the aetiology of external inflammatory resorption?
The pulp is necrotic- bacterial or dental trauma in origin
Progressive resorption of external root surface following damaged PDL surface, resulting from infected necrotic pulp tissue releasing bacterial toxins that move up the dentinal tubules and stimulating the osteoclasts to resorb the root.
This results in cementum and bone resorption
What is the treatment of external inflammatory resorption?
Remove the cause of the inflammation
Orthograde endodontic (re)treatment possibly surgical endodontics or extraction
What is the aetiology of external replacement resorption?
Trauma- significant injuries to the periodontium such that bone is then in contact with external root dentine to begin resorption
e.g. avulsion or lateral luxation
What is the treatment of external replacement resorption?
Decoronation (if infraocclusion is more than 1mm in a growing patient)
-remove crown to alveolar level and allow root to resorb
-this preserves bone volume and adjacent teeth and periodontium to develop normally
Monitor
Endodontic intervention will not stop the resorption
Can add composite incisally due to infraocclusion
