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Periodontology > Root Resorption > Flashcards

Root Resorption Flashcards

1
Q

What is root resorption?

A

Physiological or pathological loss of dentine, cementum or bone

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2
Q

What are the aetiologies for internal root resorption?

A
  • Caries
  • Trauma
  • Tooth fracture
  • HZV infection
  • Idiopathic

–> bacterial into pulp -> chronic inflammation

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3
Q

What are the types of internal root resorption?

A
  1. Inflammatory

2. Replacement

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4
Q

What are the clinical signs of internal root resorption?

A
  • Asymptomatic
  • Variable pulp tests (depends where vital pulp causing inflammation is/ remaining from replacement)
  • Later stages -> periapical tissue involvement -> abscess
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5
Q

What are the radiographical signs of inflammatory internal root resorption?

A
  • Uniform, round enlarged radiolucency in canal
  • Relationship to canal remains same with diff XR views
  • Undetectable in early stages (2D), CBCT useful
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6
Q

How is inflammatory internal root resorption managed?

A

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
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7
Q

What are the radiographical signs of replacement internal root resorption?

A
  • Radiodense material in canal (less dense than dentine)

- Irregular enlargement of canal

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8
Q

What are the types of external root resorption?

A
  • External surface
  • External inflammatory
  • External replacement
  • Transient apical breakdown
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9
Q

What is the prognosis for external surface resorption?

A
  • Self-limiting
  • Found in most teeth
  • Physiologica/ post-traumatic due to repair process to cementum

Not normally detected clinically OR radiographically

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10
Q

What are the types of external inflammatory resorption?

A
  • Apical

- Cervical (/ periodontal)

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11
Q

What is the pathogenesis of external apical inflammatory resorption?

A
  1. NECROTIC PULP
  2. Reaches apical tissues
  3. Stimulates inflammatory response
  4. Resorption
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12
Q

What are the clinical signs of external apical inflammatory resorption?

A
  • Pulp test = negative
  • TTP
  • Fistula possible
  • Mobility if extensive
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13
Q

What are the radiological signs of external apical inflammatory resorption?

A
  • Widen PDL
  • Loass of lamina dura
  • Apex irregular and ragged
  • Moth-eaten appearance
  • Shortened apex
  • Canal intact
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14
Q

How is external apical inflammatory resorption managed?

A
  • RCT

- CaOH dressing 6-24 months

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15
Q

What are the aetiologies of pressure-induced external resorption?

A
  • Ortho
  • Ectopic/ impacted teeth
  • Occlusal forces
  • Tumours
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16
Q

What is the difference between pressure-induced and inflammatory resorption?

A

Pressure-induced = pulp still vital

17
Q

What are the aetiologies of external cervical inflammatory resorption?

A
  • Trauma
  • Ortho
  • Perio disease
  • Perio therapy
  • Intra-coronal bleaching
18
Q

What are the signs of external cervical inflammatory resorption?

A
  • Usually asymptomatic

- Pink spot seen at cervical margin = high vascular granulation tissue response within tooth (dentine is thinned out)

19
Q

What is seen radiographically in a tooth with external cervical inflammatory resorption?

A
  • Moth eaten appearance

- Irregular radiolucencies at cervical 1/3 extending onto surfaces/ PDL

20
Q

What are the classification of external cervical inflammatory resorption?

A
  1. Small resorptive lesion, cervical region, shallow penetration into dentine
  2. Well-defined resorptive lesion, penetration close to coronal pulp, no/ little extension down root
  3. Deeper resorptive lesion, involves coronal dentine AND extension into coronal 1/3 root
  4. Large resorptive lesion extending beyond coronal 1/3 of root
21
Q

How is external cervical inflammatory resorption managed?

A
  • Extr
  • Topical 90% trichloroacetic acid + RSD + restore
  • RCT if pulp involved
22
Q

What is the pathogenesis of external replacement resorption?

A
  • Necrotic/ damaged PDL
  • Ortho, luxation, re-implantation
  • External surface replaced with bone i.e. ankylosis
23
Q

What are the clinical signs of external replacement resorption?

A
  • Metallic percussion note
  • Colour change
  • Ortho positive pulp test
  • Trauma negative pulp test
24
Q

What are the radiographical signs of external replacement resorption?

A
  • No/ lack of PDL space
  • Canal obliteration
  • Blunt apex but smooth
25
Q

What is transient apical breakdown?

A
  • Phenomenon which apex shows radiographic resorption following trauma/ ortho but returns to normal within 1 yr
  • Self limiting

Periodontology (11 decks)

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