Abstract
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. This review article explains the etiology, the prevalence of IRR, and, in addition to the clinical data, the contribution of the three-dimensional imaging (CBCT) to the diagnosis, the clinical decision, and the therapeutic management of IRR. The authors discussed the various therapeutic options including the orthograde or retrograde fillings of the root canal resorption area. 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. The authors describe with different clinical cases the modern endodontic techniques including optical aids, ultrasonic improvement of chemical debridement, and the use of alternative materials such as calcium silicate combined with thermoplastic filling (warm gutta-percha). In these conditions, the prognosis of the conservative treatment of internal resorptions, even if root walls are perforated, is good.
Highlights
Resorption is a condition associated with either a physiologic or a pathologic process resulting in a loss of dentin, cementum, and/or bone [1]
Internal root resorption (IRR) is a pathologic phenomenon characterized by the loss of dentine as a result of clastic cells action
From the information collected by clinical examination and Cone beam computerized tomography (CBCT), several options may be considered: (1) therapeutic abstention and monitoring, in absence of infectious signs and symptoms, (2) orthograde root canal treatment, with three options depending on the absence or presence of perforation of the radicular wall: complete root canal filling with gutta percha on nonperforated lesions; combined gutta percha in the root canal and MTA fillings for the perforation area; complete filling with a bioactive material (MTA or Biodentine) on apical perforated lesions located in a short root length, (3) retrograde apical treatment, (4) extraction and replacement by implants: the nonconservative treatment is indicated if the tooth is too weakened to be treated or restored
Summary
Resorption is a condition associated with either a physiologic or a pathologic process resulting in a loss of dentin, cementum, and/or bone [1]. Root resorption may occur after various injuries, including mechanical, chemical, or thermal injury. It can be classified as internal or external root resorption. Most of the articles on this subject focuses on external root resorptions [3], while the internal resorptions represent a challenge for the practitioner [4]. The diagnosis of these lesions is difficult to establish and the conventional X-ray is often inadequate. The contribution of these new ways of imaging and these new materials allow an extension of the boundaries for the conservation of teeth [7]
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