Root Resorption Flashcards
What is root resorption?
Physiological or pathological loss of dentine, cementum or bone
What are the aetiologies for internal root resorption?
- Caries
- Trauma
- Tooth fracture
- HZV infection
- Idiopathic
–> bacterial into pulp -> chronic inflammation
What are the types of internal root resorption?
- Inflammatory
2. Replacement
What are the clinical signs of internal root resorption?
- Asymptomatic
- Variable pulp tests (depends where vital pulp causing inflammation is/ remaining from replacement)
- Later stages -> periapical tissue involvement -> abscess
What are the radiographical signs of inflammatory internal root resorption?
- Uniform, round enlarged radiolucency in canal
- Relationship to canal remains same with diff XR views
- Undetectable in early stages (2D), CBCT useful
How is inflammatory internal root resorption managed?
NON-PERFORATED
- Pulpectomy to remove granulation tissue
- Irrigation with sodium hypochlorite (activated with ultrasonic)
PERFORATED
- Pulpectomy -> CaOH/ MTa
- Root extrusion with ortho, crown lengthening
- Resection
- Extraction
What are the radiographical signs of replacement internal root resorption?
- Radiodense material in canal (less dense than dentine)
- Irregular enlargement of canal
What are the types of external root resorption?
- External surface
- External inflammatory
- External replacement
- Transient apical breakdown
What is the prognosis for external surface resorption?
- Self-limiting
- Found in most teeth
- Physiologica/ post-traumatic due to repair process to cementum
Not normally detected clinically OR radiographically
What are the types of external inflammatory resorption?
- Apical
- Cervical (/ periodontal)
What is the pathogenesis of external apical inflammatory resorption?
- NECROTIC PULP
- Reaches apical tissues
- Stimulates inflammatory response
- Resorption
What are the clinical signs of external apical inflammatory resorption?
- Pulp test = negative
- TTP
- Fistula possible
- Mobility if extensive
What are the radiological signs of external apical inflammatory resorption?
- Widen PDL
- Loass of lamina dura
- Apex irregular and ragged
- Moth-eaten appearance
- Shortened apex
- Canal intact
How is external apical inflammatory resorption managed?
- RCT
- CaOH dressing 6-24 months
What are the aetiologies of pressure-induced external resorption?
- Ortho
- Ectopic/ impacted teeth
- Occlusal forces
- Tumours
What is the difference between pressure-induced and inflammatory resorption?
Pressure-induced = pulp still vital
What are the aetiologies of external cervical inflammatory resorption?
- Trauma
- Ortho
- Perio disease
- Perio therapy
- Intra-coronal bleaching
What are the signs of external cervical inflammatory resorption?
- Usually asymptomatic
- Pink spot seen at cervical margin = high vascular granulation tissue response within tooth (dentine is thinned out)
What is seen radiographically in a tooth with external cervical inflammatory resorption?
- Moth eaten appearance
- Irregular radiolucencies at cervical 1/3 extending onto surfaces/ PDL
What are the classification of external cervical inflammatory resorption?
- Small resorptive lesion, cervical region, shallow penetration into dentine
- Well-defined resorptive lesion, penetration close to coronal pulp, no/ little extension down root
- Deeper resorptive lesion, involves coronal dentine AND extension into coronal 1/3 root
- Large resorptive lesion extending beyond coronal 1/3 of root
How is external cervical inflammatory resorption managed?
- Extr
- Topical 90% trichloroacetic acid + RSD + restore
- RCT if pulp involved
What is the pathogenesis of external replacement resorption?
- Necrotic/ damaged PDL
- Ortho, luxation, re-implantation
- External surface replaced with bone i.e. ankylosis
What are the clinical signs of external replacement resorption?
- Metallic percussion note
- Colour change
- Ortho positive pulp test
- Trauma negative pulp test
What are the radiographical signs of external replacement resorption?
- No/ lack of PDL space
- Canal obliteration
- Blunt apex but smooth
