what is root resorption
non bacterial destruction of the dental hard and soft tissues due to the interaction of clastic cells
what is RANKL stimulated by
(increase in bone resorption)
parathyroid hormone
bacterial liposaccharides
trauma
chronic inflammation
what are the 2 types of internal root resorption
inflammatory
replacement
what are the 4 types of external root resorption
inflammatory
replacement
surface
cervical
how can internal and external resorption be differentiated on radiographs
internal - loss of parallel lines of root canal system
external - parallel lines still in tact (resorption may be superimposed on top)
external resorption will move during beam shift when doing parallax, internal will not move
internal inflammatory RR
- clinical findings
- sensibility test
- treatment
- no obvious clinical findings, incidental finding
- positive response to sensibility tests (at one point pulp is necrotic but vitality fuels resorption, will continue until entire apical pulp is necrotic)
- orthograde endodontics
internal replacement root resorption
- incidence
- clinical appearance
- radiographic appearance
- very rare, will probably never see
- no clinical findings, incidental finding
- trabecular looking pulp chamber on x ray
external inflammatory RR
- sensibility test
- radiograph presentation
- treatment
- negative sensibility test - pulp is necrotic
- periapical radiolucency and shortened root(s)
- endodontic treatment or extraction
(pulp is necrotic, bacterial or dental trauma in origin, periapical radiolucency precipitates resorption process)
External Replacement RR
- clinical findings
- potential cause
- radiograph findings
- treatment
high percussion note, tooth may be infraoccluded
usually due to trauma (avulsion, intrusion, lateral luxation)
radiograph - pulp appears normal parallel lines intact, no periapical radiolucency, no obvious PDL in some/ all regions, root area replaced with bone
- treatment if pt growing - decoronation, if stopped growing, potential composite build ups if infra occluded
external cervical root resorption
- clinical findings
- sensibility testing
- radiographic findings
- risk factors
- treatment
- pink spot lesion on crown, profuse BOP in area of resorption
- positive sensibility testing
- parallel lines of root canal system intact, parallax can help determine what surface affected, lesion in coronal portion of root
- orthodontics, trauma, wind instruments
- surgical endodontics and extraction and prosthesis
what type of root resorption require surgical endodontics
external cervical
what two types of root resorption will endodontic treatment have no impact on
external replacement
external surface
external surface RR
- clinical findings
- radiographic findings
- aetiology
- treatment
- normal on examination, possible slight mobility , positive sensibility
- PDL remains intact , parallel lines of root canal system remain, shortened root
- orthodontics, ectopic teeth, pathological lesions, idiopathic
- remove any potential cause e.g orthodontic appliance
how can external replacement and external surface resorption be differentiated
external surface the PDL remains intact
in replacement PDL is lost
what two types of root resorption is orthograde endodontics a treatment option
external inflammatory
internal inflammatory
