Cbct in treatment planning of external cervical resorption. Cases with external cervical resorption or internal resorption that i am not treating but monitoring. Root resorption has been defined as the loss of dental hard tissue as a result of osteoclastic cell action 1 and can occur on both external and internal surfaces. Root resorption is a poorly understood phenomenon and is often misdiagnosed and, as a result, inappropriately treated. Sep 10, 2016 this type of external root resorption is often seen radiographically as an extensive periradicular radiolucency associated with an extensive inflammatory response to endodontic pathosis. Genetic factors in external apical root resorption and. Joe volume 35, number 5, may 2009 external cervical resorption 619 40 also presented a case report of progressive ecr in a patient who had received periodontal regenerative treatment with guided tissue. Odontoclastic multinuclear cells are responsible for the resorption, which can grow to perforate the root if untreated.
One problem that can shorten the life of your teeth is root resorption, which is a breakdown or destruction of the root of a tooth or teeth. Root resorption diagnosis, classification and treatment choices. External resorption external resorption originates in the pdl and is recognized by an irregular radiolucent area overlying the root canal. This means that the substance of a tooth is broken down by certain specialised body cells and then absorbed. If remained unchecked, resorption can eventually lead to loss of the tooth. External root resorption could be surface, inflammatory, replacement, and cervical resorption. External root resorption after orthodontic treatment. Root resorption can be categorised into two main groups. This is a case report of a 38 yo female that noticed a reddish pink hue coming through her tooth and decided to have it examined. Root resorption diagnosis, classification and treatment. Apical external root resorption is ultimately repaired by cellular cementum but nevertheless may result in permanent loss of root length. The american association of endodontics defines resorption as, a condition associated with either physiologic or a pathologic process resulting in a loss of dentin, cementum, andor bone.
Root resorption is a condition associated with either a physiologic or a pathologic process resulting in a loss of dentin, cementum andor bone it may be initiated in the periodontium and affect initially the external surfaces of the tooth external resorption or it may start within the pulp space. Orthodontics and external apical root resorption shaza k. Apr 26, 20 inflammatory resorption occurs when the predentin or precementum becomes mineralized, mechanically damaged or scraped off. Mucosal fenestration is a clinical condition in which the overlying gingiva is denuded and the root is exposed to the oral cavity.
Significant correlations between the change in overbite and the amount of root resorption were found in maxillary and mandibular central incisors and mandi18 external root resorption after orthodontic treatment. Root resorption is a pathological process involving loss of hard dental tissues. Tooth resorption is loss of hard dental tissue, but not from decay. Management of internal root resorption on permanent teeth. Invasive cervical root resorption, external cervical resorption, and external invasive cervical root resorption oh my. Root resorption in permanent teeth may begin on the inside of the tooth internal resorption, but more often it starts from the outside and works inward external resorption. It occurs when there has been loss of cementum due to damage to the external surface of the tooth root during trauma, plus the root canal system has become. Many factors have been investigated to explain differences seen among individuals in their susceptibility to earr. Even in the presence of periradicular inflammation, resorption will occur primarily on the bone side of the attachment apparatus and the root will be resistant to it fig. Adequate root canal treatment controls intrapulpal bacteria and arrests the resorption process. External root resorption associated with impacted third.
Jun 26, 2017 invasive cervical root resorption, external cervical resorption, and external invasive cervical root resorption oh my. Aug 08, 2017 external root resorption can be further classified into surface resorption, external inflammatory resorption, external replacement resorption, external cervical resorption, and transient apical breakdown. Her dentist referred her to an oral surgeon for a tooth extraction, but she decided to have a second opinion at our office. The treatment consists of thoroughly cleaning out and disinfecting the root or nerve and the defect caused by the resorption. The author conducted a search with electronic databases medline, pubmed, scopus, us national library of medicine about frequency of external root resorption in maxilla, similar radiological images and.
Resorption is a general term for what happens when one part of the body absorbs or draws in another part. External root resorption is a progressive and destructive loss of tooth structure, initiated by a mineralized or denuded area of the root surface. Interventions for the management of external root resorption. It is caused by orthodontic loadinduced sterile inflammation that brings about resorption of the superficial root cementum, or it can become more severe with eventual resorption of the underlying dentin.
Internal inflammatory root resorption is a relatively rare resorption that begins in the root canal and destroys surrounding dental hard tissues. Root resorption is a condition associated with either a physiologic or a pathologic process resulting in a loss of dentin, cementum andor bone it may be initiated in the periodontium and affect initially the external surfaces of the tooth external resorption or it may start within the pulp space affecting primarily the. The ins and outs of root resorption british dental journal. External root resorptions are processes in which the loss of cementoblasts occurs causing the mineralized surfaces to be susceptible to the action of clastic cells. Walsh, dds, detroit an effort has been made to ar rive at a predictable method for correctly differentiatinq internal and external root resorption. Our central hypothesis is that in addition to the environmental component increased stress and strain on the teeth, surrounding periodontal ligament, and alveolar bone. What are internal and external resorption and the causes. The key features of the various types external surface. Extreme root resorption associated with induced tooth. Sometimes external resorption is not easy to diagnose from the radiograph when the canal outline is indistinct. This case presents an invasive cervical resorption of maxillary right central incisor with fenestration at the cervical third of the tooth. Management of external invasive cervical resorption tooth with. Clinical management of two root resorption cases in endodontic. May 24, 20 root resorption has been defined as the loss of dental hard tissue as a result of osteoclastic cell action 1 and can occur on both external and internal surfaces.
Jul 14, 2016 external resorption 71 external inflammatory root resorption 72. Prevention and management of external inflammatory resorption. Allen ali nasseh illustrates a case report for nonsurgical root canal treatment and the surgical repair of an extensive external root resorption defect introduction the applications of biocerami. Although many theories have been put forward, the reason for the resistance of the root to resorption is not fully understood. Management of mucosal fenestration with external root. The effects of external cervical resorption ecr, which you seem to be describing, occur near the gum line at the cervical necklike region of a tooth. Aug, 2014 using calcium hydroxide to endodontically treat teeth with external root resorption induced by chronic periapical periodontitis or pulp necrosis including byproducts adhered to the root structure implies in making good use of its antimicrobial and antiinflammatory properties, especially its alkalizing effect. Our central hypothesis is that in addition to the environmental component increased stress and strain on the teeth, surrounding periodontal ligament, and alveolar bone secondary to occlusal. Root resorption is a pathological condition that may be an endodontic challenge if not diagnosed and treated correctly. It is caused by localised and limited injury to root surface or surrounding tissues. Intrapulpal infection is the stimulation factor in internal root resorption and external periradicular inflammatory root resorption.
Cone beam computed tomography provides a more precise view of the dental structures, resulting in a more exact diagnosis 1. View the article pdf and any associated supplements and figures for a period of 48 hours. Invasive cervical resorption is a clinical term used to describe a relatively uncommon, insidious, and often aggressive form of external root resorption. In the developing child there is a natural physiological resorption of the roots to allow for the exfoliation, or shedding of the. Inflammatory resorption occurs when the predentin or precementum becomes mineralized, mechanically damaged or scraped off. External inflammatory root resorption has been further categorized into cervical resorption with or without a vital pulp invasive cervical root resorption and external apical root resorption earr ne et al. Using calcium hydroxide to endodontically treat teeth with external root resorption induced by chronic periapical periodontitis or pulp necrosis including byproducts adhered to the root structure implies in making good use of its antimicrobial and antiinflammatory properties, especially its alkalizing effect. Invasive cervical resorption icr is a clinical condition which exhibits a relatively uncommon and often aggressive form of external tooth.
External root resorption is when the bodys own immune system dissolves the tooth root structure. Assessment of external root resorptiona radiographic study. External inflammatory root resorption is a process that starts from minor lesions of the periodontal ligament andor cementum, due to trauma or contamination with bacteria that induce small root resorption cavities, reaching the dentinal tubules and the root canal. Internal and external root resorption tampa root canal therapy. Resorption is a condition associated with either physiologic or a pathologic process resulting in a loss of dentin, cementum, andor bone. A history of trauma and orthodontic treatment also contribute to the results of external root resorption.
Tooth resorption presentation, causes and treatment. We discussed two types of resorption, internal and external root resorption. The pattern of resorption may vary according to the aetiology, type and severity. In this article, we report three cases of root resorption with. Efforts by the orthodontist to avoid heavy forces on the traumatized tooth may have minimized the tendency for root resorption. As discussed, resorption is a process in which tooth structure is eaten away due to the bodys response when the tooth is subjected to trauma, an infection or other stimuli. It may occur as a consequence of dental trauma, orthodontic treatment, and. Root resorption after root canal beverly hills root resorption treatment. We all hope that our teeth will last a lifetime but many of us know that this is not often the case. It occurs differently in various areas and tissues, but tooth resorption refers specifically to the inflammation and loss of dentin inner tissue or cementum outer material to absorption, according to the american association of endodontists aae. Orthodontics and external apical root resorption seminars. Surgical management of invasive external cervical root. Assessment of external root resorptiona radiographic.
External and internal tooth resorption brampton dentist. Clinical management of severe external root resorption. A combined surgical and nonsurgical approach to repair an. External resorption treatment considerationsprognosis favorable questionable unfavorable external resorption minimal loss of tooth structure located cervically but above the crestal bone the lesion is accessible for repair apical root resorption associated with a tooth exhibiting pulp necrosis and apical pathosis minimal impact on. Lots of names but all the same biological process and same are synonyms.
In both cases of external root resorption or internal root resorption the condition cannot be ignored. It is also indicative of an infection superimposed on a traumatic injury commonly seen in both avulsion and luxation injuries. In cervical root resorption, infection originates from the periodontal sulcus and stimulates the pathological process. We report clinical case of external root resorption in maxilla.
External apical root resorption earr is a common complication of orthodontic treatment. External inflammatory root resorption is a process that starts. Left untreated, total tooth destruction is inevitable and extraction or pulling the tooth is the only option. It is a selflimiting process and is a often and incidental radiographic finding. May 11, 2018 root resorption is a poorly understood phenomenon and is often misdiagnosed and, as a result, inappropriately treated. The recent advances in the imaging technologies and material science have enabled the clinician to visualize the structural changes accurately and repair them with materials providing favourable seal ability. Scientific articles differential diagnosis of internal and external root resorption arnold h. External root resorption can be further classified into surface resorption, external inflammatory resorption, external replacement resorption, external cervical resorption, and transient apical breakdown. Invasive cervical resorption is an entirely uncommon entity and its aetiology is poorly understood. Additional reading how to prevent root resorption using the golden rule of orthodontics. Transient inflammatory resorption undergoes healing and should be monitored only.
Pdf the ins and outs of root resorption researchgate. The treatment of root resorption is basically root and or periodontal endodontic treatment, depending on the location and extent of the reabsorption. Introductionthe clinical presentation of invasive external cervical root resorption iecr varies considerably and usually involves painless destruction of tooth structure that can often go unnoticed by patients and clinicians alike. The degree and severity of earr associated with orthodontic treatment are multifactorial, involving host and environmental factors. External cervical root resorption arises at the cervical margin as a result of various insults to the periodontium periodontal disease, trauma, tooth bleaching, orthodontic treatment, surgery. This type of external root resorption is often seen radiographically as an extensive periradicular radiolucency associated with an extensive inflammatory response to endodontic pathosis. Resorption thus causes some of a tooth, generally in the root area, to just disappear. External root resorption associated with impacted third molars. The objectives of this article are to report a case of external root resorption of the. External resorption 71 external inflammatory root resorption 72. The initiating factor in internal root resorption is thought to be trauma or chronic pulpal inflammation, but other etiological. Resorption is both a physiological and pathological process which results in loss of hard tissues of the tooth, i. Differential diagnosis of internal and external root resorption.
Use of biodentine in the treatment of invasive cervical. Apical external root resorption and repair in orthodontic. We included randomised controlled trials of permanent teeth with any type of external root resorption, which has been confirmed by clinical and. Differential diagnosis of internal and external root. External cervical resorption treatment options ecir ecr. Nithin mathew external inflammatory root resorption etiology.
Contemporary orthodontics has attained a high degree of proficiency, undoubtedly due to the valuable technical refinements as well as innovations in the field of materials used in orthodontics. The initiating factor in internal root resorption is thought to be trauma or. Root resorption after root canal beverly hills root. It appears that if irregularities of root contour indicative of apical external root resorption are not detected within six to nine months of commencement of orthodontic treatment, then it would be unlikely that any significant apical external root resorption will occur, but if any apical external root resorption is observed within six to nine.
External apical root resorption earr is a common sequela of orthodontic treatment, although it may also occur in the absence of orthodontic treatment. While some teeth with highly vascular granulation tissue within the. Pdf orthodontics and external apical root resorption. The aim of this paper is to provide a practical guide for diagnosis of root. In spite of such advances taking place in all aspects of orthodontics, external apical root resorption earr, particularly in the region of upper incisors, is an almost ubiquitous. Root canal treatment remains the treatment of choice of internal root resorption as it removes the granulation tissue and blood supply of the clastic cells.
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