Tooth resorption

External tooth root resorption

• A pathological process in which the roots of permanent teeth are resorbed.
• We distinguish:

1. Internal resorption (starts inside the tooth from the pulp side);
   • causes: pulpitis chronica clausa, does not cause problems.
2. External resorption (begins on the outer surface of the root from the periodontium);
   • causes: periapical inflammation, tumors, cysts, retained teeth, replanted teeth

Internal resorption

• File:Resorption classification.png
  is caused by a chronic inflammatory process (pulpitis chronica granulomatosis interna)
  • the resulting granulation tissue resorbs the surrounding dentin and cementum* if it is in the neck --> typical sign - 'pink spot
• Therapy:
  • endodontic treatment
  • temporary filling made of Ca(OH)₂ or other bioactive materials (MTA, Biodentine,...)

External resorption

• external resorption generally occurs as a result of damage to the periodontal ligaments (whether mechanical, chemical or biological)
• the surrounding tissue reacts to this stimulus, it tries to break down the damaged tissue
• as part of this, TZT will also be resorbed
• subclassification:
  • replacement resorption
    • resorbed TZT are replaced by bone that grows into them
    • a solid dentin-bone connection is formed = ankylosis
  • inflammatory resorption
    • cause - from dentin (necrosis, infection)
      • toxins reach the periodontium through the dentinal tubules
      • granulation tissue is formed
      • followed by resorption
  • invasive cervical resorption
    • starts from cells below the epithelial attachment
    • cells resorb the cervical region of the tooth
    • we distinguish 4 types according to severity
  • surface resorption
    • e.g. as a result of orthodontic treatment
      • in the area of ​​the pressure zone, hyaline necrosis of periodontal vessels will occur as a result of excessive pressure
      • surrounding tissue reacts to necrosis
      • results in small resorptions visible on the root of the tooth
  • pressure resorption
    • due to excessive occlusal forces
  • idiopathic resorption
    • for an unknown reason
• Therapy
  • depends on the extent of the defect and location
    • if it is a small defect in the neck area
      1. extirpation of granulation tissue
      2. Ca(OH)₂ or other bioactive material
      3. Emdogain
    • in the apex area
      • tip resection possible
    • otherwise we can try endodontic treatment and hope

Links

https://www.slideshare.net/UDDent/root-resorption-stdntcopy

https://www.researchgate.net/figure/Classification-of-root-resorption-A-Replacement-resorption-The-root-is-resorbed-and_fig1_225830442

Related Articles

• Abrasion (Dentistry)
• Atrice
• Erosion

References

• LIŠKA, Karel. Orofacial Pathology. 1. edition. publisher, 1983. 159 pp. ISBN 3180840161.

• WEBER, Thomas. Memorix of Dentistry :  translation 2nd edition, 279 illustrations. 1. edition. Prague : Grada, 2006. 430 pp. ISBN 80-247-1017-X.