Abstract

BackgroundThe objective of this scoping review was to systematically explore the current knowledge of cellular and molecular processes that drive and control trauma-associated root resorption, to identify research gaps and to provide a basis for improved prevention and therapy.MethodsFour major bibliographic databases were searched according to the research question up to February 2021 and supplemented manually. Reports on physiologic, histologic, anatomic and clinical aspects of root resorption following dental trauma were included. Duplicates were removed, the collected material was screened by title/abstract and assessed for eligibility based on the full text. Relevant aspects were extracted, organized and summarized.Results846 papers were identified as relevant for a qualitative summary. Consideration of pathophysiological mechanisms concerning trauma-related root resorption in the literature is sparse. Whereas some forms of resorption have been explored thoroughly, the etiology of others, particularly invasive cervical resorption, is still under debate, resulting in inadequate diagnostics and heterogeneous clinical recommendations. Effective therapies for progressive replacement resorptions have not been established. Whereas the discovery of the RANKL/RANK/OPG system is essential to our understanding of resorptive processes, many questions regarding the functional regulation of osteo-/odontoclasts remain unanswered.ConclusionsThis scoping review provides an overview of existing evidence, but also identifies knowledge gaps that need to be addressed by continued laboratory and clinical research.

Highlights

  • The objective of this scoping review was to systematically explore the current knowledge of cellular and molecular processes that drive and control trauma-associated root resorption, to identify research gaps and to provide a basis for improved prevention and therapy

  • Whereas pulp necrosis can usually be treated without much difficulty, extensive damage to the periodontium is irrepairable

  • Damage to pulp and periodontium may result in root resorption, a pathological process characterized by progressive loss of cementum and dentine due to clastic cellular activity [7]

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Summary

Introduction

The objective of this scoping review was to systematically explore the current knowledge of cellular and molecular processes that drive and control trauma-associated root resorption, to identify research gaps and to provide a basis for improved prevention and therapy. Damage to pulp and periodontium may result in root resorption, a pathological process characterized by progressive loss of cementum and dentine due to clastic cellular activity [7]. Permanent teeth are protected from resorption by barriers, on the root surface by a layer of cementum, within the endodontium by a layer of predentine [9, 10]. Damage to these protective layers, e.g. after dental trauma, exposes the underlying dentine and makes it accessible to clastic cells [10], which can bind exclusively to mineralized tissue surfaces to initiate the resorptive process [11,12,13]. A recent investigation among adolescents reported a risk of root resorption after dental trauma to be 2.3% [14]

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