Why not to treat the tooth canal to solve external root resorptions? Here are the principles!

Alberto Consolaro,Graziella Bittencourt

doi:10.1590/2177-6709.21.6.020-025.oin

Alberto Consolaro, Graziella Bittencourt

Open Access

https://doi.org/10.1590/2177-6709.21.6.020-025.oin

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Abstract

ABSTRACTThis paper aims at exposing the foundations or reasons why, in cases of external tooth resorption, including those of orthodontic origin, one should not perform a root canal to treat it. That should be done only to teeth with contamination or pulp necrosis, to remove the periapical inflammation induced by microbial products. When facing cases of external tooth resorption, one's conduct must always respect the following sequence of steps: first of all, identifying the cause accurately; then, planning the therapeutic approach and, finally, adopting the conducts in a very well-founded way. The situations in which endodontic treatment is recommended for tooth resorptions are those when there are: a) pulp necrosis with microbial contamination, b) aseptic pulp necrosis, c) developing calcific metamorphosis of the pulp and d) diagnosis of internal resorption. It is not possible, through the pulp, to control the resorption process that is taking place in the external part, after all, the causes are acting in the periodontal ligament. There is no evidence that justifies applying endodontic treatment, by means of root canal, to control external resorption processes, when the pulp shows vitality.

Highlights

Este artigo tem por objetivo principal expor os fundamentos ou razões pelas quais, em casos de dentes com reabsorção dentária externa, incluindo as de origem ortodôntica, não se deve fazer o canal para tratá-la
When it comes to this type of tooth resorption, if the cause is extinguished and this inflammation disappears, the process will be interrupted
The professional must check for pulp vitality and thoroughly analyze the pulp space, in order to reject the possibility of processes that would be simultaneous and independent on external tooth resorptions, which are, respectively, aseptic pulp necrosis and pulp calcific metamorphosis. If none of these pulpopathies induced by dental trauma is found, nothing justifies endodontic treatment for this type of paralyzed inflammatory external tooth resorption

Summary

Introduction

Este artigo tem por objetivo principal expor os fundamentos ou razões pelas quais, em casos de dentes com reabsorção dentária externa, incluindo as de origem ortodôntica, não se deve fazer o canal para tratá-la. DENTAL PULP HAS NOTHING TO DO WITH EXTERNAL RESORPTIONS: THESE ARE THE FOUR WAYS OF STARTING A TOOTH RESORPTION Tooth resorptions may begin in four ways (Fig 1): 1) By destruction exclusively of the cementoblasts in the external part of the root, but leaving the other periodontal structures alive, with varying inflammation degrees.

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