Few cases of multiple idiopathic external cervical root resorption exist in the literature. They can be classified as internal, when root canal is involved and external, when. Root resorption treatment is directly related to the causative factor. Management of inflammatory root resorption using mta. Internal resorption is often difficult to detect in posterior teeth and may be seen only after root treatment has. It may occur as a consequence of dental trauma, orthodontic treatment, and. Management of external perforating root resorption by. The treatment of root resorption is basically root and or periodontal endodontic. In this report we present two cases of root resorption and describe means for its clinical management. External tooth resorption has been classified into four types based on clinical and histological features, namely, external surface resorption, external inflammatory root resorption, replacement resorption, and ankylosis. The adequate root canal treatment will provide sufficient control of bacteria and hence cease the resorption process. Often management of unusual cases will require some deviation from standard treatment techniques. Minimal apical external root resorption may be present in all permanent teeth and has been attributed to a variety of causes.
Possible etiologic factors in external root resorption. It is usually asymptomatic and detected during routine radiographic investigations. Management of internal root resorption on permanent teeth. The following two cases demonstrate internal and external inflammatory root resorption arrest by conventional nonsurgical endodontic therapy combined with calcium hydroxideiodoform dressing, mineral trioxide aggregate mta and flowable guttapercha system. External root resorption periodontally derived develops on the external surface of the tooth root, is accompanied by concomitant alveolar bone resorption, and its causes can be periapical inflammatory processes, excessive pressure forces exerted on the tooth root during orthodontic treatment or the rapid development of a tumor process 3. However, upto now only numerated cases of idiopathic apical root resorption have been reported in the literature. Case report clinical management of two root resorption.
Root resorption is a pathological process involving loss of hard dental tissues. Case report clinical management of two root resorption cases. This difference exists because the defect of the internal resorption is the result of the deformation of the dentin walls in a space that will be occupied by the root canal, while the external resorption is separated. Internal resorption is a relatively rare resorption of dentine, which starts in the pulpal cavity either in the pulpal chamber or in the root canal and destroys surrounding dental hard tissues. 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. Cone beam computed tomography provides a more precise view of the dental structures, resulting in a more exact diagnosis 1. Pdf internal and external root resorption management.
Case report introduction tooth resorption maybe physiological shedding of primary tooth or a pathological process, that involves resorption of dentin, cementum, bone and sometimes the enamel. Aim to present two cases of external root resorption and in so doing highlight rarer causative factors as well as the difficulties in classifying root resorption. Internal resorption is a pathological process, that affects the tooth. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. In internal resorption the outline of the canal is interrupted and usually appears as a smooth bulge. Once internal root resorption has been diagnosed, the prognosis of the tooth is dependent on whether the lesion communicates with the external surface of the root making nonsurgical root canal treatment difficult due to risk of extrusion through the perforation between internal and external root surfaces. Tooth resorption may be external, when it is initiated in the periodontium and. Case report clinical management of two root resorption cases in endodontic practice jozefmincik, 1 danielurban, 2 andsilviatimkova 3 private dental practice, vystavby, kosice, slovakia mint dental, private dental practice, ostravska, kosice, slovakia facultyof medicine,departmentof dentistryandmaxillofacial surgery, pavol jozef safarik. Clinical management of two root resorption cases in. Objects closer to the source of radiation will move distally in relation to objects farther from the volume 49 number 2 endodontic management of extensive internal roororption 165 source.
Tooth resorption, or root resorption, is the progressive loss of dentine and cementum by the action of osteoclasts. Internal root resorption irr is a particular category of pulp disease considered as the loss of dentine as a result of the action of clastic cells stimulated by pulpal inflammation. In internal root resorption, pulp vitality is required at least in the apical third of the root. This report is presented two cases of root resorption external cervical resorption and inflammatory ir in traumatized teeth where cone beam computed tomography has been used as an important diagnostic tool.
Apr 26, 20 the following two cases demonstrate internal and external inflammatory root resorption arrest by conventional nonsurgical endodontic therapy combined with calcium hydroxideiodoform dressing, mineral trioxide aggregate mta and flowable guttapercha system. Endodontic management of extensive internal root resorption. Large resorption defects may result in penetration of the tooth into the periodontium through the cementum. Since this phenomenon is a progressing condition and once started, it tends to affect the entire tooth, it would be better to get to know the anatomy of the tooth first. Internal resorption occurs when the natural protection of the predentin and odontoblasts in the root canal is damaged or removed due to the transformation of embryonic connective tissue cells into giant multinucleate odontoclasts. Treatment of invasive cervical resorption with sandwich. Clinical management of two root resorption cases in endodontic. Internal resorption ir is a progressive process initiated within the pulp space. Cases of external apical root resorption were excluded if the apical resorption was due to a necrotic or devitalized tooth, periapical inflammatory disease, advanced periodontal disease, history of a systemic disorder associated with apical root resorption, history of trauma, or history of orthodontics. Management of a case of internal root resorption is a challenge to the endodontists. Root resorption is the loss of hard dental structures under the action of clastic cells, which can also be accompanied by bone tissue loss. Breakthrough clinicals editorial director stacey simmons, dds, says, not everything we do in dentistry is black and white and therein lies the conundrum oftentimes the chief complaint is difficult to pinpoint, and the pathology is. Simultaneous occurrence of internal and external resorption with apical breakdown that often results in open apex is a rare condition and is challenging for the clinician.
Resorption can be defined as a condition associated with either a physiologic or a pathologic process resulting in a loss of dentin, cementum andor bone. In both situations, root resorption requires the presence of blood supply allowing migration of clastic cells. Although it is predominantly detected by radiography, in some cases root resorption may be identified by clinical symptoms such as pain, swelling and mobility of the. Following root canal treatment, intentional replantation of the tooth was performed so as to expose the opening of the resorption defect to allow for complete. Root resorption and signs of repair in papillonlefevre syndrome.
Management of external invasive cervical resorption tooth. External root resorption associated with impacted third. Multiple idiopathic external and internal resorption. The following two cases demonstrate internal and external inflammatory root resorption arrest by conventional nonsurgical endodontic therapy combined with calcium hydroxideiodoform dressing. The goldstandard treatment consists of debridement. In this article, we report three cases of root resorption with. 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. In this report we present two cases of root resorption and describe means for its clinical. This article describes a rare case of multiple idiopathic external and internal resorption in the. We conclude that useful measure of a success or failure in managing root resorption is the. It may occur in cases with chronic pulpal inflammation, following caries or due to trauma in the form of an accidental blow.
External periapical inflammatory root resorption see case 1 and internal. However, in the secondary dentition the process is pathological. Diagnosis and management of root resorption in traumatized teeth. The use of cone beam computed tomography in the diagnosis and management of internal root resorption associated with chronic apical periodontitis. In this case the tooth was diagnosed as having external resorption, it was deemed nonrestorable, and it was treatment planned for extraction and bone graft under iv sedation. Apr 10, 2010 this case report deals with successfull management of tooth with an otherwise hopeless prognosis. External root resorption associated with impacted third molars. Internal root resorption irr is a particular category of pulp disease characterized by the loss of dentine as a result of the action of clastic cells stimulated by pulpal inflammation. Summary root resorption in the permanent dentition is usually pathological. Internal root resorptionirr is a particular category of pulp disease considered as the loss of dentine as a result of the action of clastic cells stimulated by pulpal inflammation. There 4 distinct layered parts of the human tooth, namely, enamel, dentin, the pulp and the root canal.
Management of internal root resorption a case report. Effective management of external cervical resorption ecr depends on accurate assessment of the true nature and accessibility of ecr. Wide open apical foramen is more difficult to manage and the root canal may often overfill. The initiating factor in internal root resorption is thought to be trauma or chronic pulpal inflammation, but other aetiological factors have also been suggested. Internal root resorption is observed daily in practice and with early detection especially with the use of technology and cbct scans, diagnosis and management, the prognosis for rendered treatment can be favorable. The use of cone beam computed tomography in the management of external cervical resorption lesions. The patient has been regularly recalled every 6 months and radiographically the apical. Management included a surgical access, osteotomy and sealing of the resorptive defect with geristore, followed by orthograde retreatment. Mar 17, 2016 minimal apical external root resorption may be present in all permanent teeth and has been attributed to a variety of causes. A number of theories have been proposed as a possible cause for internal resorption.
Internal resorption can often be treated by a timely root canal, but external resorption can continue to persist after a root canal procedure. 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. Internal resorption of teeth is an insidious process and is generally found in teeth with previous history of trauma. Use of cbct may be an important diagnostic tool in this regard.
External root resorption is a pathological process, which tends to occur following a wide range of mechanical or chemical stimuli such as infection, pressure, trauma or orthodontic tooth movement. Cervical external root resorption in vital teeth bergmans. A thorough history along with radiographic and clinical assessments are critical. Saveetha dental college, poonamallee high road, vellapanchavadi. Local factors are the most frequent causes of resorption, most commonly excessive pressure and inflammation. This creates a communication between the internal and external. Internal inflammatory root resorption is characterised by progressive destruction of intraradicular dentin and dentinal tubules along the root canal wall.
Treatment of external cervical resorption involved endodontics and periodontics. The objectives of this article are to report a case of external root resorption of the. He gave a history of previous endodontic treatment in that tooth fifteen years back. This feature differentiates external resorption from internal resorption. A radiographic evaluation is essential to the diagnosis and the difficulty in distinguishing this lesion from internal root resorption. Multiple idiopathic external cervical root resorption. Different materials have been proposed for the treatment of external. Root resorption is a pathological condition that may be an endodontic challenge if not diagnosed and treated correctly. Regarding the treatment of external resorption, successful management of each case must be linked to the etiology. Diagnosis and management of root resorption in traumatized. The numerous resources available offer significant aid in the diagnosis and treatment of such lesions. It appears to be a progressive condition, and there has been no detectable frequency for its occurrence, regions affected in the dentition, or whether singlemultiple quadrants are involved liang, et al.
The following two cases demonstrate internal and external inflammatory root resorption arrest by conventional nonsurgical endodontic therapy combined with. This case report describes the surgical management of a rootfilled maxillary incisor with persistent apical periodontitis and extensive iecr where diagnosis and treatment planning were assisted by cbct imaging. External inflammatory root resorption is a process that starts from minor lesions of the periodontal ligament and or cementum, due to trauma or contamination with bacteria that induce small root resorption cavities, reaching the dentinal tubules and the root canal. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. A differential diagnosis of external root resorption and external cervical resorption should be included in such cases of root resorption. In most cases diagnosis is simple but occasionally it may be difficult to differentiate between internal and external resorption. This case report deals with successfull management of tooth with an otherwise hopeless prognosis.
In this present case report, we shall be discussing an unusual simultaneous occurrence of noncommunicating internal and external resorption with open apex and its management. Surgical management of invasive external cervical root. In most cases, invasive cervical resorption is found during routine radiographic or clinical examination. Idiopathic external root resorption of the entire dentition. However, in the present case, the radiographic features were typical of internal root resorption, that is, the lesion was smooth, symmetrically distributed over the root and had a uniform density, as. External periapical inflammatory root resorption see case 1 and internal root resorption see case 2 are caused by pulpal infection 17. It appears to be a progressive condition, and there has been no detectable frequency for its occurrence, regions affected in the dentition, or whether singlemultiple quadrants are. This report is presented two cases of root resorption external. Two radiographs are exposedne perpendicular to the tooth and the other from an angle mesial to the perpendicular in the same horizontal plane. This is a normal physiological process in the exfoliation of the primary dentition, caused by osteoclast differentiation due to pressure exerted by the erupting permanent tooth.
Invasive cervical resorption icr is a relatively uncommon form of external root resorption. Interventions for the management of external root resorption. Distinguishing differences between internal and external resorption. Resorption can broadly be classified as external resorption, internal resorption or both depending upon the location of the process. Management of internal and external resorption with open. The purpose of this article is to describe a case involving extensive internal root resorption. The patient has been regularly recalled every 6 months and radiographically the apical lesion showed signs of healing and arrest of root resorption after 1 year and 6 months. The full text of this article hosted at is unavailable due to technical difficulties. 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. 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. External periapical inflammatory root resorption see case 1 and internal root resorption see case 2 are caused by pulpal infection. Cbct in the management of internal root resorption. 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. Root resorption of a tooth is a pathological process of internal or external origin.