Root resorption Flashcards
resorption definition
a condition associated with either physiologic or a pathologic process resulting in a loss of dentin , cementum, and /or bone
physiologic resorption
like primary teeth loss
resorption in permanent teeth is usually?
pathologic
- internal or external
which resopriton is more prevelant?
external
definition of internal resoprtion
a pathologic process initiated within the pulp space with loss of dentin and possinle invasion of the cementum
may or may not perforate to the external root surface
etiology of internal root resoprtion
- truama
- infected coronal pulp
- metaplastic tissue - tissue capable of resoprtion from somewhere else comes here?
- extreme hear during cutting
prerequisite for internal resoprtion
loss or alteration of the odontoblastic layer and predentin
loss of what layer with internal resoprtion
odontoblastic layer
histology of intenral resorption
- granulation tissue with multi-nucleated giant cells
- loss of odontoblastic layer
- nectrotic pulp coronal to granulation tissue
- bacteria in dentinal tubules
- no adjacent bone resorption
cells you will see in resorptino
multi-nucleated giant cells
external surface of bone in internal resoprtion ***
in tact!!
- not the case all the time in external
clinical manifestations of internal resoprtion
- asympotomatic
- discovered in routine radiographs
- vital pulp
- pink tooth
internal resoprtion radiographic feature
fairly uniform radiolucent enlargment of the pulp canal
internal resorption treatment
perform root canal therapy as soon as possible
internal resoprtion prognosis
good!
but decreases to fair or poor f perforated externally
definition of external resorption
resorption initiated in the periodontium and initially affecting the external surfaces of the tooth
surface resorption
a PHYSIOLOGIC process causing small superficial defects in the cementum and underlying dentin that undergo REPAIR by deposition of new cementum
root surface undergoes small area of minimla loss of cemntum and dentin – spontaneous repaire usually
classification of external resoprtion
- surface
- replacement
- inflammatory
replacement resorption - describe
aka
replaced actively by bone – relacement
basically anklyosis
inflammatory replacement - describe
resoprtion root but also erosino of pulp– erosion of bone and dentin
etiology and histology of surface resoprtion
minor luxation injury
orthodontic movement
small resoprtive lacunae with local inflammatory response
surface resoprtion sympotamic?
usually - no
RADIOGRAHIC appearance
or invisible?
replacement resoprtion definiton
a PTHOLOGIC loss of cementum, dentin, and periodontal ligament with the INGROWTH of bone into the defect and fusion of bone to dentin with a loss of physiologic mobility and the LACK OF RADIOLUCENCY at the resorptive interface
which resorptions are pathologic vs physiologic?
surface is physiologic whereas replacement and inflammatory are pathologic
histology of replacement
direct contact between bone and dentin without separating periodontal ligament and cemental layer
etiology of replacement resorption
- extensive trauma
2. replantation
clinical manifestations of replacement resorption
- lack of mobility
- metallic sound to percussion
- infraocclusoin in the developing dentition
- ultimately tooth is lost due to loss of root support
definiton of inflammatory resorpton
PATHOLOGIC loss of cementum, dentin, and BONE resulting in the root and adjacent bony tissue
classification of inflammatory resorption
- cervical
- lateral
- apical
etiology of inflammatory resorption
- dental trauma
- pulp necoriss
- excessive mechanical forces
- intracoronal bleaching
- pressure from impacted teeth
- tumors
- replantation
histology of inflammatory resorption
- periodontal infliltrate with lymphocytes, plasma cells, and polymorphonuclear leukocytes
- multiucleated giant cells resorbign root surface
breakdown of external resorption
- surface
- replacement
- inflammatory
pulp is usually vital in which two categories of inflammatory external resorptions
- cervical
2. lateral
cellls responsible for inflammatory resorption whethr internal or external
multi-nucleated giant cells
inflammatory ressoprtion radiographic appearance
progressive radiolucent areas of the root and adjacent bone
mottled appearance
pink spot seen in?
cervical inflammatory resorption
and internal resorptions
clinical manifestations of inflammatory resorption
depends on pulpal status – can see pink spit in cervical resorption
is cervical inflammatory resorpotion within the pulp?
NO
pulpal status in apical inflammatory resorption? implication in treatment
NECROTIC – SO TX WITH ENDO THERAPY — good prognosis
lateral inflammatory resorption pulpal status? treatment?
if nectoric – perform endo treatment
early diangosis is key
Ca(OH)2 medicament
could be reversed
surgical treatment if needed
pulpal status of inflammatory cervical resoprtion
usually vital
pulp plays a role but could get exposed
may presetn as reversible pulpitis
overview of extern al resoprtion
- resorption initiated in the periodontium and initially affecting the external surfaces of a tooth
- surface, inflammatory, or replacement
- cervical lateral or apical
radiographic features of internal resoprtion vs external
root canal outline is distorted
- root canal and the defect appear contigous
EXTERNAL
- root canal outline is NORMAL
- appears ‘running through’ radiolucent defect
- take a CT scan
T/F external resorption is always accompanied by resorption of bone
TRUE – important radiographic feature when distinguishing external resorption from internal
positive vs negative vitality testing in external and internal resorption
internal and inflammatory cervical external resorption
negative inapical and lateral inflammatory resorption
internal resorption only happens with vital pulp?
YES
