The four mechanisms of dental resorption initiation

Alberto Consolaro

doi:10.1590/s2176-94512013000300004

Abstract

The aim of this study is to present a classification with a clinical application for root resorption, so that diagnosis will be more objective and immediately linked to the source of the problem, leading the clinician to automatically develop the likely treatment plan with a precise prognosis. With this purpose, we suggest putting together all diagnosed dental resorptions into one of these four criteria: 1) Root resorption caused by cementoblast cell death, with preservation of the Malassez epithelial rests. 2) Root resorption by cementoblasts and Malassez epithelial rests death. 3) Dental resorption by odontoblasts cell death with preservation of pulp vitality. 4) Dental resorption by direct exposure of dentin to gingival connective tissue at the cementoenamel junction gaps.

Highlights

The aim of this study is to present a classification with a clinical application for root resorption, so that diagnosis will be more objective and immediately linked to the source of the problem, leading the clinician to automatically develop the likely treatment plan with a precise prognosis
We suggest putting together all diagnosed dental resorptions into one of these four criteria: 1) Root resorption caused by cementoblast cell death, with preservation of the Malassez epithelial rests
Inflammatory dental resorptions1 are maintained by inflammatory mediators that stimulate BMUs — Bone Multicellular Units — where clastic cells gradually resorb the dentin surface free of cementoblasts and odontoblasts, eliminated as a consequence of the resorption process

Summary

Alberto Consolaro*

The aim of this study is to present a classification with a clinical application for root resorption, so that diagnosis will be more objective and immediately linked to the source of the problem, leading the clinician to automatically develop the likely treatment plan with a precise prognosis With this purpose, we suggest putting together all diagnosed dental resorptions into one of these four criteria: 1) Root resorption caused by cementoblast cell death, with preservation of the Malassez epithelial rests. Dental resorptions by replacement are maintained by systemic and local mediators of bone tissue which regulate the remodelling process or turnover This resorption occurs always as a consequence of alveolodental ankylosis because of the death of Malassez epithelial rest cells — induced by dental trauma, especially by daily concussions.

Periodontal Ligament

Dentin at the CEJ gaps was exposed to gingival connective tissue