Cervical Root Resorption Research Articles

Multiple idiopathic cervical root resorption most frequently seen in younger females

Medline and references of included studies were used to source articles. Selected articles were case reports or reviews of patients who had multiple root resorption with no systemic or local factors that may have contributed to root resorption, the resorption originating at the cemento-enamel junction of teeth and involving more than three teeth in the dentition. Clinical, histological and historical findings are summarised for all identified patients. Multiple idiopathic cervical root resorption (MICRR) was an incidental finding on routine clinical and radiographic examination. There appeared to be no correlation between this type of resorption and any medical or dental finding. Radiographically, MICRR was found to begin at the cemento-enamel junction and then either progress to involve the entire cervical region or, at some point, spontaneously arrest. Those cases that progressed to involve the entire cervical region required extraction. The number of teeth that demonstrated this condition ranged from five up to 24 per patient. More teeth became involved as the condition was followed in time. There was no detectable frequency of occurrence for any particular dental region or tooth among the involved teeth. Of a total of 18 patients, 13 were females whose ages ranged from 7 to 68 years of age. Ten of the 18 patients were Caucasian. Multiple idiopathic cervical root resorption was found most frequently associated with younger females. This condition appeared to be of unknown aetiology and uncertain natural history.

Root resorption--diagnosis, classification and treatment choices based on stimulation factors.

Etiology of different types of root resorption requires two phases: mechanical or chemical injury to the protective tissues and stimulation by infection or pressure. Injury can be similar in various types of root resorption. The selection of proper treatment is related to the stimulation factors. Intrapulpal infection is the stimulation factor in internal root resorption and external periradicular inflammatory root resorption. Adequate root canal treatment controls intrapulpal bacteria and arrests the resorption process. In cervical root resorption, infection originates from the periodontal sulcus and stimulates the pathological process. As adequate infection control in the sulcus is unlikely, removal of granulation tissue from the resorption lacuna and sealing are necessary for repair. Removal of the stimulation factor, i.e. pressure, is the treatment of choice in root resorption related to pressure during orthodontic treatment, or an impacted tooth or tumor. In ankylotic root resorption, there is no known stimulation factor; thus, no predictable treatment can be suggested. Therefore, various types of root resorptions can be classified according to the stimulation factors: pulpal infection resorption, periodontal infection resorption, orthodontic pressure resorption, impacted tooth or tumor pressure resorption, and ankylotic resorption.

Tooth bleaching--a critical review of the biological aspects.

Present tooth-bleaching techniques are based upon hydrogen peroxide as the active agent. It is applied directly, or produced in a chemical reaction from sodium perborate or carbamide peroxide. More than 90% immediate success has been reported for intracoronal bleaching of non-vital teeth, and in the period of 1-8 years' observation time, from 10 to 40% of the initially successfully treated teeth needed re-treatment. Cervical root resorption is a possible consequence of internal bleaching and is more frequently observed in teeth treated with the thermo-catalytic procedure. When the external tooth-bleaching technique is used, the first subjective change in tooth color may be observed after 2-4 nights of tooth bleaching, and more than 90% satisfactory results have been reported. Tooth sensitivity is a common side-effect of external tooth bleaching observed in 15%-78% of the patients, but clinical studies addressing the risk of other adverse effects are lacking. Direct contact with hydrogen peroxide induced genotoxic effects in bacteria and cultured cells, whereas the effect was reduced or abolished in the presence of metabolizing enzymes. Several tumor-promoting studies, including the hamster cheek pouch model, indicated that hydrogen peroxide might act as a promoter. Multiple exposures of hydrogen peroxide have resulted in localized effects on the gastric mucosa, decreased food consumption, reduced weight gain, and blood chemistry changes in mice and rats. Our risk assessment revealed that a sufficient safety level was not reached in certain clinical situations of external tooth bleaching, such as bleaching one tooth arch with 35% carbamide peroxide, using several applications per day of 22% carbamide peroxide, and bleaching both arches simultaneously with 22% carbamide peroxide. The recommendation is to avoid using concentrations higher than 10% carbamide peroxide when one performs external bleaching. We advocate a selective use of external tooth bleaching based on high ethical standards and professional judgment.

Cervical Root Resorption in Two Patients With Unilateral Complete Cleft of the Lip and Palate

Abstract Objective: Case reports on cervical root resorption in patients with complete cleft of the lip and palate are scarce. Moreover, cervical root resorption is sometimes diagnosed several years after a combined orthodontic and surgical therapy in patients with cleft. In this article a review of the literature is presented, and a description and the management of the cervical lesion is provided. An additional objective of this report is to advocate for alveolar bone grafting before the age of 12 years while the vulnerable cervical region of the teeth adjacent to the cleft defect is still protected by a thick layer of bone.

Evaluation of pH variation and cervical dentin permeability in teeth submitted to bleaching treatment

External cervical root resorption is one of the disadvantages of the bleaching procedure. There are several mechanisms that may be responsible for causing resorption, such as the chemical and physical action of the utilized materials and the morphology of the cementoenamel junction. The purpose of this study was to investigate the presence of a communication between the pulp chamber and the external root surface. The investigation was carried out by means of pH tests and measurement of dye infiltration into cervical dentin after the bleaching procedure. Thirty-four human permanent incisors were submitted to endodontic treatment. The teeth were assigned to three experimental groups, according to the level at which the filling was cut, and to the sealing of the root canal entrance with glass ionomer cement. Sodium perborate and 30% hydrogen peroxide were utilized for bleaching. pH readings were carried out after 30 minutes, 24 h, 48 h and 72 h from the beginning of the procedure. The teeth were immersed in 0.5% basic fuchsin for 24 h in order to determine possible differences in the permeability of cervical dentin. The results revealed that pH tended to change when the root filling was cut at the entrance of the canal, when 2 mm of the filling were removed, and when the canal entrance was sealed with glass ionomer. Dentinal permeability increased in the three experimental groups, in comparison with the control group. These slight differences may suggest a communication between the pulp chamber and the external root surface.

Bleaching effect of carbamide peroxide gel on discolored nonvital teeth

The bleaching of discolored nonvital teeth is conservative treatment that satisfy the cosmetic desire. The most common method for this treatment, walking bleaching, is using 30% hydrogen peroxide and sodium perborate. Many alternatives are suggested for preventing the external cervical root resorption that is the common complication of the nonvital teeth bleaching with 30% hydrogen peroxide The same extent of oxidation reactions as that resulted by the bleaching with the application of 30% hydrogen peroxide and sodium perborate can also be acquired more safely by materials that contain 10% carbamide peroxide, used primarily for the bleaching of vital teeth. Therefore, this study was performed to evaluate the efficacy of 10% and 15% carbamide peroxide bleaching gel in nonvatal teeth bleaching. The internal bleaching of intentionally discolored teeth was performed in vitro with 10% carbamide peroxide (Group 1), 15% carbamide peroxide (Group 2), mixture of distilled water and sodium perborate (Group 3), and mixture of 30% hydrogen peroxide and sodium perborate (Group 4). The bleaching materials were refreshed following 3, 6, 9 and 12 days. To evaluate the bleaching effect, the color change of the crowns was measured at 1, 2, 3, 4, 7 and 15 days of bleaching using the colorimeter. The results were as follows：1. L and E values were increased with time in all bleaching agents (p and E value among bleaching agents. 3. E value higher than 3 was shown after 3 days of bleaching with 10% carbamide peroxide gel, 1 day with 15% carbamide poroxide gel, 4 days with mixture sodium perborate and distilled water and 4 days with mixture sodium perborate and 30% hydrogen peroride, respectively. These results revealed that the use of 10% and 15% carbamide peroxide bleaching gel in non-vital teeth bleaching is as effective as mixture of distilled water and sodium perborate and mixture of 30% hydrogen peroxide and sodium perborate. Accordingly, carbamide peroxide could be used clinically to bleach discolored non-vital teeth.

Generalized cervical root resorption associated with periodontal disease

AbstractBackground and description of case: The etiology and pathogenesis of generalized cervical root resorptions is not well understood. In the present report, a case of severe cervical root resorption involving 24 anterior and posterior teeth is presented. The lesions developed within a period of 2 years after the patient had changed to an acid‐enriched diet. They extended far into the coronal dentin and were associated with gingival inflammation and crestal bone resorption. However, no generalized clinical attachment loss had occurred. Culturing of subgingival plaque revealed the presence of several putative periodontal pathogens among which Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Treatment consisted of mechanical debridement supported by systemic antibiotics (amoxycillin plus metronidazole) and dietary advice.Results: Within 1 year after the onset of treatment, all resorptive lesions had repaired by ingrowth of a radio‐opaque mineralized tissue. The crestal areas showed radiological evidence of bone repair. 3 years after the onset of therapy, one premolar was extracted and examined histologically. It appeared that irregularly‐shaped masses of woven bone‐like tissue had invaded into the domain of the resorbed coronal dentin and were bordered by thin layers of acellular cementum.Conclusion: It is concluded that, in this patient, the cervical resorptions were likely the result of an osteoclastic response extending into the roots because the root‐protective role of the junctional epithelium did not develop. We hypothesize that this was due to the combined effects of a periodontopathogenic microflora and a dietary confounding factor.

Cementoenamel Junction: Microscopic Analysis and External Cervical Resorption

There is a lack of data regarding the shapes and distribution of the mineralized tissue that composes the cementoenamel junction. A sample of 198 permanent human teeth was analyzed by optical microscopy and scanning electron microscopy. Scanning electron microscopy showed three types of tissue interrelations: enamel overlapped by cementum; enamel and cementum edge-to-edge; and a gap, revealing a strip of exposed dentin. Using optical microscopy, a fourth type of cementoenamel junction was observed: cementum overlapped by enamel. The distribution of the hard tissues found at the cementoenamel junction is unpredictable and irregular both for any tooth type (e.g. on cuspids) and on any one individual tooth. Based on these results and on analysis of the mechanisms involved in cervical root resorption, it is possible to consider the cervical region as prone to external resorption.

Report of a Case: Multiple Idiopathic Cervical Root Resorption

Report of a Case: Multiple Idiopathic Cervical Root Resorption

Alveolar bone grafting: a review of 115 patients.

The results of alveolar bone grafting carried out at The Hospital for Sick Children, Great Ormond Street, London, UK, between January 1982 and January 1989 were assessed. Cancellous bone from the iliac crest was grafted to alveolar cleft defects in 115 patients (63 male and 52 female). Eighty-seven unilateral (58 left and 29 right) and 28 bilateral clefts were operated on. The mean age at the time of operation was 11.5 years, with a range of 8.08-18.75 years. The cleft canine had erupted prior to bone grafting in 58.4 per cent. At the time of this study the cleft had erupted in 96.35 per cent and was unerupted in 3.65 per cent of sites. Radiographs were taken at regular intervals and assessed according to previously reported criteria. Eighty-six per cent were clinically successful (Type I and II). In Type III 10.95 per cent had less than three-quarters of the normal interdental septal height and 2.18 per cent failed (Type IV). In addition, 3.6 per cent of sites showed cervical root resorption affecting the adjacent incisor and 1.4 per cent internal resorption of the cleft canine.

The effect of the bleaching agent sodium perborate on macrophage adhesion in vitro: Implications in external cervical root resorption

The purpose of this study was to investigate the in vitro effect of sodium perborate, which is used as a bleaching agent in the treatment of discolored pulpless teeth, on substrate adherence capacity of macrophages. Inflammatory macrophages were obtained from Wistar rats and resuspended in RPMI-1640 medium. As a test of macrophage adhesion, the adherence capacity of macrophages to a plastic surface was determined. Assays were conducted in Eppendorf tubes for 15 min of incubation at 37 degrees C in a humidified atmosphere of 5% CO2. The adherence index was calculated. Results showed that sodium perborate decreased in a dose-dependent manner and decreased significantly (p < 0.05) the adherence index of rat peritoneal macrophages. Sodium perborate was less potent than sodium hypochlorite and eugenol in inhibiting macrophage adhesion. The inhibitory effect of sodium perborate on macrophage adhesion further supports the concept that this agent is not implicated in external cervical root resorption associated with intracoronal bleaching.

Hydroxyl radical activity in thermo‐catalytically bleached root‐filled teeth

Intra-coronal bleaching of root-filled teeth has been associated with invasive cervical root resorption. It is considered that during bleaching hydrogen peroxide diffuses through the tooth structure into the cervical periodontium, resulting in periodontal tissue destruction and initiating a resorptive process. Hydrogen peroxide is capable of generating hydroxyl radical, an oxygen-derived free radical, in the presence of ferrous salts. Hydroxyl radicals are extremely reactive and have been shown to degrade components of connective tissue, particularly collagen and hyaluronic acid. The aim of the present study was to determine whether hydroxyl radicals are generated during the bleaching of root-filled teeth which have been discoloured by blood. Forty extracted human premolar teeth were root-filled with gutta-percha and AH26 sealer cement. Twenty of the teeth were experimentally discoloured by blood. All teeth were then thermo-catalytically bleached using 30% hydrogen peroxide while tooth roots were seated in a test solution of sodium salicylate. Hydroxyl radical generation was determined by the detection of reaction products of this radical with salicylate using high performance liquid chromatography with electrochemical detection (HPLC-ECD). The presence of hydroxyl radicals was detected in twenty-five of the teeth. There was a significant association between the production of hydroxyl radicals and the presence of tooth discolouration caused by blood components. Greatest yields of hydroxyl radicals occurred in teeth in which EDTA had been used to clean the pulp chamber prior to bleaching. It was concluded that hydroxyl radicals are generated during the thermo-catalytic bleaching of root-filled teeth. Generation of this toxic chemical species may be one mechanism underlying periodontal tissue destruction and root resorption after intra-coronal bleaching.

CERVICAL ROOT RESORPTION

This article describes cervical root resorption, an external inflammatory root resorption arising immediately below the attachment level of the root. The pathogenesis is not fully understood, although many theories have been presented. Clinically, cervical root resorption is usually asymptomatic. The radiographic appearance is variable and is easily mistaken for that of internal root resorption. Histologically, the presentation is identical to that of other inflammatory root resorptions.

OR 55 Single-tooth implants in endodontics: results and experiences of a retrospective study after 4 years

OO__R I ,Single-tooth implants in enclodonUcs: results and experiences of a retrospective study after 4 years R HERNANDEZ DMD*, TJ BALSHI DDS FACP The aim of this study is to present results and experiences of a retrospective analysis of single-tooth replacement for endodontically failed teeth using osseointegrated implants in immediate extraction sites. 94 Brn vertical root fractures, 17 (22%); trauma, 13 (16.8); horizontal root fracture, 4 (5.1); cervical root resorption, 4 (5.1%); furcation or root perforation, 4 (5.1%); combined endodontic/periodontic lesions, 3 (3.8%); presence of pain after endodontic therapy, 3 (3.8%); fistula not resolved, 1 (1.2%); other, 5 (6.45%). All patients were followed for 4 years focusing on implant success and crown function. Plaque and gingival indexes, and probing depths were recorded around teeth and implants. Only 5 implants (5.3%) were lost by the first annual check-up; none after. A total of 89 implants were clinically and radiographically evaluated at the 4 year recall, resulting in a cumulative success rate of 99.5% in the maxilla (59 implants) and 97% (30 implants) in the mandible. Plaque and gingival indexes showed good health around both natural teeth and tissue integrated prostheses. The outcome of this study indicated that safe and highly predictable results can be obtained when osseo nte.qrated implants are used to immediately replace endodontically failed teeth.

Tissue Characteristics of Root Resorption Areas in Transplanted Maxillary Canines

Berglundh T, Thilander B, Sagne S. Tissue characteristics of root resorption areas in transplanted, maxillary canines.The aim of the present study was to describe some histopathologic features of tissues collected from root resorption areas of maxillary canines after transalveolar transplantation surgery. In 8 of 101 transplanted canines, complications including cervical root resorption occurred between 6 and 11 years after treatment, The resorptive processes were located at the supra-alveolar portions of the distal and/or mesial aspects of the teeth and were scheduled for treatment involving surgical exploration. The resorption cavities, which extended from the cementoenamel junction to a position immediately below the bone crest, were tilled with a granulation tissue. In four of the diagnosed complication cases, this granulation tissue was carefully excised concomitant with the adjacent gingival tissue after flap elevation and placed in a buffered fixative. After proper soft-tissue healing, the cavities were filled with a glass-ionomer material. The collected biopsy specimens were, after fixation and, in one case, decalcification in ethylenediaminetetraacetic acid, dehydrated and embedded in Epon. Sections 3 pm thick were produced, stained in periodic acid-Schiff and toluidine blue, and used for histometric and morphometric analyses. The histologic analysis showed that the dissected tissue harbored well-encapsulated areas of inflammatory infiltrates. The lesions, comprised a relatively low- volume of collagen and a large number of inflammatory cells, predominantly lymphocytes.

Role of cementoenamel junction on the radicular penetration of 30% hydrogen peroxide during intracoronal bleaching in vitro.

Intracoronal bleaching of nonvital, teeth with 30% hydrogen peroxide is occasionally associated with external cervical root resorption. The exact mechanism by which bleaching induced root resorption occurs is not yet fully understood. The relationship of cementum to the enamel at the cementoenamel junction may have clinical significance. Seventeen single rooted human mandibular premolars extracted atraumatically for orthodontic reasons were used. The radicular hydrogen peroxide penetration in each tooth was measured in vitro by an indirect colorimetric method. Thereafter, the teeth were examined with a scanning electron microscope to determine the type of the cementoenamel junction. It was found that the radicular penetration of 30% hydrogen peroxide was related to the type of cementoenamel junction.

Invasive Cervical Root Resorption

Australian Endodontic NewsletterVolume 22, Issue 1 p. 24-25 Invasive Cervical Root Resorption First published: April 1996 https://doi.org/10.1111/j.1747-4477.1996.tb00021.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume22, Issue1April 1996Pages 24-25 RelatedInformation

Radicular penetration of hydrogen peroxide during intra‐coronal bleaching with various forms of sodium perborate

The development of external cervical root resorption following internal bleaching of discoloured pulpless teeth is associated with the use of hydrogen peroxide. The aim of the study was to determine radicular penetration of hydrogen peroxide following intracoronal bleaching with various forms of sodium perborate. 63 extracted human incisors were root filled and stained artificially. Standardized cementum defects were created on the mesial and distal aspects of the root directly below the cemento-enamel junction (CEJ). Using the walking bleach technique all teeth were bleached for a 6-day period, with replacement of the bleaching paste after days 1 and 3. Sodium perborate monohydrate (MH), trihydrate (TRH) or tetrahydrate (TH) was mixed with H2O2 or H2O and subsequently placed intracoronally 1 mm below the labial CEJ. The teeth were divided into six groups: I. MH + H2O2(30%) (n = 12); II. TRH + H2O2(30%) (n = 12); III. TH + H2O2(30%) (n = 12); IV. TH + H2O (n = 12); V. TH + H2O, gel (n = 12); VI. no bleaching paste (n = 3). At baseline and at days 1, 3 and 6 the amount of H2O2 taken up from the surrounding medium of each root was indirectly recorded and calculated as p.p.m. Almost all teeth of the experimental groups showed leakage of hydrogen peroxide compared to those of the control group. The radicular penetration of hydrogen peroxide was significantly higher in teeth of groups I and III than in those of groups IV and V (P < or = 0.001). In conclusion, the amount of hydrogen peroxide leakage depends, among other factors, on the form of sodium perborate used.(ABSTRACT TRUNCATED AT 250 WORDS)

A method to determine the location and shape of an intracoronal bleach barrier

The external cervical root resorption associated with intracoronal bleaching of pulpless teeth can be a devastating lesion. It often cannot be repaired. To prevent this problem, increasing attention has been focused on placing a barrier between the pulp chamber and the endodontic filling material. The objective of this article is to propose a method for determining the location and shape of an intracoronal bleach barrier.

Effect of intracoronal bleaching on external cervical root resorption

The purpose of this study was to examine histologically and radiographically the effect of a bleaching agent, a mixture of sodium perborate and superoxol (30% hydrogen peroxide), without a heat source on the cervical root surface and periodontal tissue of endodontically treated teeth of dogs. Endodontic treatment was performed on anterior teeth of dogs. The endodontically treated teeth were then divided into two groups. One group received walking bleach procedures, while the other group did not. The animals were killed at intervals of 1 and 3 months after bleaching for histological and radiographic examination. External cervical root resorption was only observed in bleached teeth at 3-month but not at 1-month observation.