The treatment of root resorption is basically root and. This microscope observation by an endodontist suggested a hopeless prognosis for the tooth and, hence, the recommended extraction. Before and after treatment xrays of internal resorption. Radiographs are helpful in determining the extent of resorption, but intraoral views are. Feb 08, 2012 cleaning of the root canal space with internal resorptive defect in the maxillary central incisor. Internal root resorption irr is defined as a resorptive defect of the. If the tooth has internal resorption, a root canal may not solve the problem. Initial radiograph indicating the presence of internal root resorption circled area in. They can be classified as internal, when root canal is involved and external, when periodontal ligament is involved. Symptoms diagnosis and treatment of internal resorption. Treatment for internal resorption prompt root canal treatment is necessary in all diagnosed cases of internal resorption. This paper report a case describing the diagnosis and treatment of an external root resorption in the upper right central. The best article ive seen is mavridou from joe 2016.
Performing a root canal treatment prior to onset of deep bacterial colonization is a valuable service we can provide to our. Root canal filling, excess of guttapercha in the resorptive cavity. Although these tasks might appear formidable, it is at the molecular signaling level that one anticipates the greatest expansion of horizons. By rotating the reamer 14 to 12 turn clockwise, the cutting edges scrape the canal walls as it is advanced to the working length. Regenerative endodontic treatment procedures are an alternative approach to treat perforated internal root resorption lesions. Usually root canal therapy will need to be done in this situation. An 18yearold patient presented with a previously traumatized, rootfilled maxillary central incisor associated with pain and sinus tract. Internal root resorption contributes to failure of endodontic treatment. Robert slosberg facilitates accurate mapping and obturation of the resportive defect with cbct imaging. External cervical resorption treatment options ecir ecr. Resorption of teeth is either physiological, or arises as a result of some abnormal condition or force. Root resorption is the term used for breakdown and loss of the root of the tooth.
Treatment of internal resorption is quite predictable as it is easy to control the process of internal root resorption via severing the blood supply to the resorbing tissues with conventional root canal therapy. Early diagnosis, removal of the cause, proper treatment of the resorbed root is mandatory for successful treatment outcome. Root resorption due to dental trauma endoexperience. An overview and case report of endodontic management. What we know and how it affects our clinical practice. Regenerative endodontic treatment of perforated internal. Use of biodentine in the treatment of invasive cervical. Belinda weltman hbsc, ms, dmd, bdent, msc, frcdc root resorption a physiologic or pathologic process occurring as a result of changes seen.
Kim, dds red rock endodontics this document is intended as an easytoread guide for dental students and general practitioners of different. This study concluded that root resorption is observed more frequently and its risk of development is higher in cases of severe trauma, especially avulsion and luxation. Nonsurgical endodontic retreatment of advanced inflammatory. 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. Root resorption should be treated as soon as its detected to prevent more damage from occurring, because the destruction can be rapid. I have been a faithful attendant to my teeth all my life checkups twice a year. Management of internal root resorption on permanent teeth. Root resorption after root canal beverly hills root. If the tooth is deemed restorable and has a reasonable prognosis, root canal treatment is the treatment of choice. Getting to the root of endodontic root canal treatments the goal. The damage is caused as the macrophages part of the cellular immunity of the body get converted to osteoclasts and resorb the cementum of the underlying root. Generally speaking, if the resorption is discovered before a fissure of the root occurs, root canal therapy can be used to treat resorption with a fairly high expected success rate. As early as 1914 clinical observers suggested a direct link between orthodontic treatment and root resorption.
In internal resorption the outline of the canal is interrupted and usually appears as a smooth bulge. Most cases of internal root resorption are seen in anterior teeth, due to their susceptibility to trauma. We all hope that our teeth will last a lifetime but many of us know that this is not often the case. In this case report, we describe treatment of a maxillary central incisor affected by severe, perforating external root resorption. The canal was cleaned with k files, irrigated several times with 2. Root canal treatment of internal resorption youtube. Today, they often can be saved through endodontic treatment. The root canal reamer is manufactured by twisting a tapered square or triangular shaft, but the fewer twists result in an instrument with the cutting edges more nearly parallel to its long axis. Getting to the root of endodontic root canal treatments. The pattern of resorption was consistent with class 4 extensive invasive cervical root resorption. Injury and stimulation the injury is similar to several types of root resorption injury is related to the nonmineralized tissues covering the external surface of the root, the precementum, or internal surface of the root canal, the predentin. Internal resorption is a rare lesion in permanent teeth.
Diagnosis of invasive cervical resorption by using cone. Successful endodontic treatment of internal cervical root. I had a class 3 heithersay resorption, but after the procedure the endodontist said i have a good chance of keeping the tooth. A clinical guide for dental students, general dentists who like doing rcts and general dentists who hate doing rcts greg y. Youre right, it is a harsh treatment, but its the best we have, and in most situations, it wont even help. The resorption ceases as soon as the chronically inflamed pulp is removed. Extra canal invasive resorption part 2 part 2tricity dev. Ricardo machado, emanuely da silva chrun, luiz fernando tomazinho, and lucas da fonseca roberti garcia consider the possibility of endodontic treatment of a tooth with pulp necrosis and severe inflammatory external apical root resorption in a single session educational aims and objectives this article aims to present a case. 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. This pages discusses external cervical resorption treatment options and also discusses some general information about external invasive cervical root resorption.
The treatment depends upon proper diagnosis of root resorption. Photos and xrays on symptoms diagnosis and treatment of internal resorption created in our nyc root canal office. The patient did not feel tooth pain symptoms because the nerve was nonvital. This is subject matter that is very interesting to me, mainly because i find our practice has treated a significant number of. Cleaning of the root canal space with internal resorptive defect in the maxillary central incisor. Protaper universal dentsply maillefer, usa up to finishing file number 3 f3.
Management of internal root resorption with endodontic treatment and complete root canal filling with warm gutta percha tooth 47. Root resorption after root canal beverly hills root resorption treatment. If there is a source of trauma, that should also be removed if possible. Internal root resorption is the progressive destruction of intraradicular dentin and dentinal tubules along the middle and apical thirds of the canal walls as a result of clastic activities. Internal root resorption irr is defined as a resorptive defect of the internal aspect. Internal resorption is the result of an inflamed pulp and the clastic precursor cells recruiting through the blood vessels. Internal resorption is an uncommon resorption of the tooth, which starts from the root canal and destroys the surrounding tooth structure. Why cant tooth resorption be treated more subtly than via. Internal resorption is often difficult to detect in posterior teeth and may be seen only after root treatment has been completed.
However, it may be seen in posterior teeth, most likely because of carious involvement of the pulp. Cbct evaluation of multiple idiopathic internal resorptions. If ecr has reached the area near the dental pulp the tissue housing the nerve in the tooths center, root canal treatment may also be required. This is a normal physiological process in the exfoliation of the primary dentition, caused by osteoclast differentiation due to pressure exerted by. Since its the bodys own cells that are destroying the tooth, treatment can range from the removal of those cells, a root canal or even extraction. I have to decide between root canal or extraction and. Abstract a patient presented with advanced internal root resorption of tooth no. Extra canal invasive resorption ecir is a type of external root resorption that usually starts in the cervical region, below the epithelial attachment of any permanent tooth, leading to the replacement of tooth structure with highly vascular tissue containing clastic cells. Little is known about the causes of predentin protective damage. Extra canal invasive resorption part 1 tricity dev. Diagnosis of invasive cervical resorption by using cone beam. I have to decide between root canal or extraction and implant. Successful endodontic treatment of internal cervical root resorption may 2, 2017 by marina polonsky. This is subject matter that is very interesting to me, mainly because i find our practice has treated a significant number of cases over the past few years involving this condition.
An 18yearold patient presented with a previously traumatized, root filled maxillary central incisor associated with pain and sinus tract. Management of tooth resorption gs heithersay abstract. 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 internal. External cervical invasive resorption is an uncommon type of root resorption that, when not detected andor treated on time, may result in the loss of a tooth. Nov 02, 2015 however, root resorption is not normal or common in adult teeth. Advances in different scientific disciplines will enrich the pool of ideas for future therapeutic strategies, apart from conventional root canal therapy, in the treatment of internal root resorption. Endodontic instruments and their uses columbia university.
However, root resorption is not normal or common in adult teeth. For those suffering resorption within the greater houston area, gulf coast endodontics provides quality houston root canals. A reciprocating singlefile system was used for root canal. Jan 20, 2014 the etiology of root resorption requires two phases. Tooth resorption, or root resorption, is the progressive loss of dentine and cementum by the action of osteoclasts. Abstract a patient presented with advanced internal root. Her dentist referred her to an oral surgeon for a tooth extraction, but she decided to have a second opinion at our office. Emphasis will be placed on preventive measures to control resorption. As well, the difficult threedimensional anatomy of the canal systems, such as internal resorption network, also makes it difficult to achieve complete debridement and disinfection of the entire surface area of the root canal walls and into the depth of the tubules. This presentation will focus on the management of cervical root resorption lesions by an internal approach with or without additional surgical intervention.
Some patients choose to try a root canal with the questionable prognosis. Frequency of root resorption following trauma to permanent teeth. This report presents a successful surgical treatment of a maxillary central incisor that had extensive root perforation. Also known as a root canal treatment, this procedure may be performed by a general dentist or a specialist called an endodontist. Eval what you would invest in a root canal and crown with buildup vs implant and crown abutment. Nonsurgical endodontic treatment was planned in relation to tooth 21 and 11. Pdf endodontic treatment of maxillary lateral incisor with internal. Management of a tooth with a large internal resorption defect. Endodontic treatment and root canal filling hot gp technique, obtura etc. Fanny yacaman is a beverly hills endodontist who specializes in the treatment of root resorption after root canal therapy. The clinical case presented here describes a successful endodontic treatment of a lower premolar, which exhibited radiographic signs of internal resorption and a buccal perforation. 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. While endodontic treatment is the preferred treatment modality for internal root resorption, current standard endodontic techniques pose a challenge for cleaning, disinfection and.
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. This report presents a successful surgical treatment of a maxillary central incisor that had extensive root perforation due to internal resorption. 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. In most cases, the pulp will necrose very quickly, which removes the blood supply to the. After 2 years, the tooth was asymptomatic and radiographic examination revealed hard tissue formation in the perforated resorption area and remodelling of the root surface. Frequency of root resorption following trauma endodontic. Internal root resorption irr, commonly referred to as intracanal resorption. Comparison by cone beam computed tomography cbct showed the same condition over time, without evolution. From a histologic perspective, internal root resorption is manifested in one form that is purely destructive, internal root canal inflammatory resorption, and another that is accompanied by repair, internal root canal replacement resorption that is featured by the deposition of metaplastic bonecementumlike tissues adjacent to the sites of. It is easy to control the process of internal root resorption via severing the blood supply to the resorbing tissues with conventional root canal therapy. She will work with you to establish a treatment plan to help you preserve your teeth. Inflammatory external root resorption is one of the major complications after traumatic dental injury. Preserving the tooth n the past, injured or diseased teeth frequently had to be removed. A case report ehsen abdelmoumen, sonia zouiten skhiri.
May 02, 2017 unfortunately, early intervention is not always possible. Extra canal invasive resorption part 1 for this weeks blog i would like to discuss extra canal invasive resorption ecir. Mineral trioxide aggregate is being increasingly used as a root canal. The canal wall should be traceable through the ecr lesion because it is superimposed over the root canal. Once internal root resorption has been diagnosed, the clinician must make a decision on the prognosis of the tooth. Review article management of internal root resorption on. This is the continuation of a blog i posted a few weeks ago.
Use of biodentine in the treatment of invasive cervical resorption. Endodontic treatment of a tooth with pulp necrosis and. Jun 26, 2017 external cervical resorption and the subset of extra canal invasive resorption can be detrimental to a tooth. Managing perforating internal resorption is a great challenge for dentists. 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. Though its ultimately very rare, root resorption in adults can be a complicated issue. Unlike conventional root canal treatment, often times the tooth will need to be medicated with calcium hydroxide or a similar medicament in order to help promote healing. Symptoms diagnosis and treatment of internal resorption nyc. To be honest, if your resorption was successfully treated by a root canal, than you are luckier than most. Various materials available for the treatment of internal root resorption. Internal resorption treatment interview with dr cornelia grau duration. Apr 16, 2014 the canal wall should be traceable through the ecr lesion because it is superimposed over the root canal. Regenerative endodontic treatment of perforated internal root.
Pdf tooth resorption is a common sequela following injuries to or irritation of the periodontal ligament andor tooth pulp. The etiology of root resorption requires two phases. Endodontic treatment of a tooth with pulp necrosis and severe. Aim to present the regenerative endodontic treatment procedure of a perforated inter. Surgical intervention for treating an extensive internal. External cervical resorption and the subset of extra canal invasive resorption can be detrimental to a tooth. B, i am currently facing extraction of two teeth in the smile zone and implants. Root resorption due to dental trauma flammatory response over the entire root surface, which, in turn, results in extensive damage to the protective layer, 14. Internal root resorption presents specific difficulties in instrumentation and filling.