Management of internal and external resorption with open. Internal resorption of teeth is an insidious process and is generally found in teeth with previous history of trauma. Internal inflammatory root resorption is characterised by progressive destruction of intraradicular dentin and dentinal tubules along the root canal wall. 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.
Different materials have been proposed for the treatment of external. 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. Few cases of multiple idiopathic external cervical root resorption exist in the literature. The following two cases demonstrate internal and external inflammatory root resorption arrest by conventional nonsurgical endodontic therapy combined with calcium hydroxideiodoform dressing. Endodontic management of extensive internal root resorption.
Management included a surgical access, osteotomy and sealing of the resorptive defect with geristore, followed by orthograde retreatment. 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. 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. 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. Internal resorption is often difficult to detect in posterior teeth and may be seen only after root treatment has.
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. A thorough history along with radiographic and clinical assessments are critical. Two radiographs are exposedne perpendicular to the tooth and the other from an angle mesial to the perpendicular in the same horizontal plane. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. External root resorption associated with impacted third. In this article, we report three cases of root resorption with. Diagnosis and management of root resorption in traumatized. Internal resorption is a pathological process, that affects the tooth. They can be classified as internal, when root canal is involved and external, when. The initiating factor in internal root resorption is thought to be trauma or chronic pulpal inflammation, but other aetiological factors have also been suggested. Idiopathic external root resorption of the entire dentition. Effective management of external cervical resorption ecr depends on accurate assessment of the true nature and accessibility of ecr. Management of external perforating root resorption by.
Root resorption is a pathological condition that may be an endodontic challenge if not diagnosed and treated correctly. Management of external invasive cervical resorption tooth. The patient has been regularly recalled every 6 months and radiographically the apical. The use of cone beam computed tomography in the diagnosis and management of internal root resorption associated with chronic apical periodontitis. In both situations, root resorption requires the presence of blood supply allowing migration of clastic cells. Multiple idiopathic external and 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. External periapical inflammatory root resorption see case 1 and internal root resorption see case 2 are caused by pulpal infection 17. In internal root resorption, pulp vitality is required at least in the apical third of the root. Surgical management of invasive external cervical 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. 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. Possible etiologic factors in external root resorption.
This case report deals with successfull management of tooth with an otherwise hopeless prognosis. Management of internal root resorption a case report. In this report we present two cases of root resorption and describe means for its clinical. Saveetha dental college, poonamallee high road, vellapanchavadi. However, in the secondary dentition the process is pathological. 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. Minimal apical external root resorption may be present in all permanent teeth and has been attributed to a variety of causes.
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. 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. External periapical inflammatory root resorption see case 1 and internal root resorption see case 2 are caused by pulpal infection. Use of cbct may be an important diagnostic tool in this regard. 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. However, upto now only numerated cases of idiopathic apical root resorption have been reported in the literature. 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. Tooth resorption may be external, when it is initiated in the periodontium and. Diagnosis and management of root resorption in traumatized teeth. Root resorption and signs of repair in papillonlefevre syndrome. 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. The use of cone beam computed tomography in the management of external cervical resorption lesions.
Root resorption treatment is directly related to the causative factor. In internal resorption the outline of the canal is interrupted and usually appears as a smooth bulge. External root resorption associated with impacted third molars. It is usually asymptomatic and detected during routine radiographic investigations. Root resorption is a pathological process involving loss of hard dental tissues. 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. Treatment of external cervical resorption involved endodontics and periodontics. The numerous resources available offer significant aid in the diagnosis and treatment of such lesions. It may occur as a consequence of dental trauma, orthodontic treatment, and. The goldstandard treatment consists of debridement. 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. In this report we present two cases of root resorption and describe means for its clinical management.
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 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. 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. Case report clinical management of two root resorption cases. Cone beam computed tomography provides a more precise view of the dental structures, resulting in a more exact diagnosis 1. Tooth resorption, or root resorption, is the progressive loss of dentine and cementum by the action of osteoclasts. In most cases, invasive cervical resorption is found during routine radiographic or clinical examination. Pdf internal and external root resorption management. Wide open apical foramen is more difficult to manage and the root canal may often overfill. 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. This feature differentiates external resorption from internal resorption. Often management of unusual cases will require some deviation from standard treatment techniques.
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 creates a communication between the internal and external. Internal resorption ir is a progressive process initiated within the pulp space. 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. The objectives of this article are to report a case of external root resorption of the. Treatment of invasive cervical resorption with sandwich. 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. Regarding the treatment of external resorption, successful management of each case must be linked to the etiology. Cervical external root resorption in vital teeth bergmans. 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. 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.
This report is presented two cases of root resorption external. 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. 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. Management of internal root resorption on permanent teeth.
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. 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. The purpose of this article is to describe a case involving extensive internal root resorption. 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. External periapical inflammatory root resorption see case 1 and internal. 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. The following two cases demonstrate internal and external inflammatory root resorption arrest by conventional nonsurgical endodontic therapy combined with. The treatment of root resorption is basically root and or periodontal endodontic.
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. Root resorption is the loss of hard dental structures under the action of clastic cells, which can also be accompanied by bone tissue loss. Root resorption of a tooth is a pathological process of internal or external origin. 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. Apr 10, 2010 this case report deals with successfull management of tooth with an otherwise hopeless prognosis. 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. Management of inflammatory root resorption using mta. A differential diagnosis of external root resorption and external cervical resorption should be included in such cases of root resorption. He gave a history of previous endodontic treatment in that tooth fifteen years back. In most cases diagnosis is simple but occasionally it may be difficult to differentiate between internal and external resorption. 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 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. Distinguishing differences between internal and external resorption. Clinical management of two root resorption cases in endodontic. Large resorption defects may result in penetration of the tooth into the periodontium through the cementum. Clinical management of two root resorption cases in. 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. We conclude that useful measure of a success or failure in managing root resorption is the. Cbct in the management of internal root resorption. Interventions for the management of external root resorption. There 4 distinct layered parts of the human tooth, namely, enamel, dentin, the pulp and the root canal.
The full text of this article hosted at is unavailable due to technical difficulties. It may occur in cases with chronic pulpal inflammation, following caries or due to trauma in the form of an accidental blow. Case report clinical management of two root resorption. Resorption can broadly be classified as external resorption, internal resorption or both depending upon the location of the process. Multiple idiopathic external cervical root resorption. This article describes a rare case of multiple idiopathic external and internal resorption in the. Mar 17, 2016 minimal apical external root resorption may be present in all permanent teeth and has been attributed to a variety of causes. Invasive cervical resorption icr is a relatively uncommon form of external root resorption.
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