External Resorption Research Articles

Survival probability of dental autotransplantation of 366 teeth over 34 years within a hospital setting in the United Kingdom

The purpose of this retrospective study was to evaluate 34 years' experience of autotransplantation of teeth during orthodontic treatment. Treatment was completed at Queen Mary's Hospital, Sidcup, Kent, UK, during the period 1969-2003. A total of 366 teeth were transplanted in 314 patients. Canines totalled 78 per cent of all autotransplanted teeth; mean age of patient was 19.4 years. Survival probability for the first 5 years post-autotransplantation was 95 per cent, 94 per cent for the subsequent 5 years, and 88 per cent after 15 years. The maximum observation period was 34 years, the median was 2.0 years, and the mean was 3.51 (standard deviation = 3.68) years. Of the observed teeth, 10 failed and these were lost due to unsuccessful periodontal ligament regeneration and persistent mobility grade III (or greater). Apical pathology was observed in 16 per cent of all autotransplanted teeth. In 79 per cent of this subgroup, apical pathology was evident in the first 3 years post-operatively. Seventy per cent of all external resorption also occurred within the first 3 years. Internal resorption was rare but its occurrence was mostly observed between the second and sixth year post-transplantation. A minority of autotransplanted teeth [14 per cent (n = 51)] needed root canal therapy, and this was completed within the first 6 months post-transplantation. Autotransplantation can be a justified procedure with good survival probability. It can be considered an alternative to other treatments, such as prosthodontic replacement of teeth.

Accuracy of Different Imaging CBCT Systems for the Detection of Natural External Radicular Resorption Cavities: An Ex Vivo Study

ObjectiveThe aim of this study was to compare the sensitivity and specificity of 3 different systems of cone-beam computed tomography (CBCT) in the detection of natural external root resorption (ERR) cavities using microtomography as the gold standard. MethodA sample of 126 ex vivo teeth were submitted to a microtomography examination to verify the presence/absence of ERR cavities. Then, they were divided into the control group: 85 teeth that did not present with an ERR cavity; and experimental group: 41 teeth that presented with 1 or more ERR cavities. The size of the natural ERR cavities varied from 2.46 mm3 to 3.11 mm3, which corresponded to cavities of 1.67 mm and 1.81 mm in diameter, respectively. The teeth were placed on a dry human mandible for scanning in each of the 3 protocols with different voxel sizes: 0.25 mm, 0.20 mm, and 0.166 mm. ResultsThe accuracy of the 3 protocols evaluated in this study are listed in decreasing order: 60.3% for a voxel size of 0.20 mm, 56.7% for a voxel size of 0.166 mm, and 46.7% for a voxel size of 0.25 mm; these are smaller values than previous studies have obtained using artificial ERR cavities. Statistically significant results were not found among the 3 CBCT protocols that were used (P > .05), and the receiver operating characteristic curve shows the small differences found between the protocols. ConclusionThe results indicate that CBCT presents, for natural ERR, lower sensitivity and specificity values than those detected in previous studies of artificial cavities. The results demonstrate that natural ERR is neither easily observed nor accurately located by CBCT, as previous studies using artificial ERR indicated.

A 22-year-old male with pain and tooth surface loss on multiple teeth

This article has no abstract. The first 100 words appear below: A 22-year-old male reported to the outpatient department with the complaints of occasional pain and tingling sensation on his maxillary left posterior teeth and mandibular anterior teeth for 3 to 4 months with slight mobility of mandibular anterior teeth. He had no significant medical history as well as no history of trauma and familial history of similar disease. He also stated that he went to Dhaka Dental College where he received clinical and radiological investigations and diagnosed as a case of external tooth resorption. In the Dhaka Dental College, upper left 1st and 2nd premolar, mandibular right central and lateral incisor teeth were extracted.

Multiple Cervical Root Resorption in a Young Adult Female Previously Treated with Chemotherapy: A Case Report

Multiple idiopathic cervical root resorption is an aggressive form of external root resorption that occurs at the cementoenamel junction and can affect multiple teeth (a minimum of 3) throughout the entire dentition. Most of the individuals affected are healthy with noncontributory medical histories. The resorption is usually detected as an incidental finding on radiographs or during dental examination. This case report describes an adult female with multiple cervical root resorptions who had been treated with chemotherapy for ovarian cancer at 16 years old. Nine years later, a total of 12 teeth were diagnosed with cervical root resorption. All of the known causative factors for external cervical resorption were discarded. To our knowledge, this is the first case reported of multiple cervical root resorption related to chemotherapy.

MODERN REPRESENTATIONS ABOUT ETIOLOGY, PATHOGENESIS, AND TREATMENT OF EXTERNAL RESORPTION OF THE TOOTH ROOT

External cervical resorption of the root of the tooth, is asymptomatic and has no characteristic morphological manifestations, to make a reliable diagnosis in most cases is impossible. External inflammatory root resorption is one of the most destructive and aggressive types of pathology. The analysis of domestic and foreign literature and publications. This article highlights the main etiological factors and pathogenesis mechanisms of external resorption of the root. Both local and systemic etiological factors can lead to the development of root resorption. Allocate superficial, inflammatory and replacement external resorption. The modern approaches to the diagnosis and treatment of this disease are considered.

Is Hypoxia Related to External Cervical Resorption? A Case Report

Despite the fact that external cervical resorption (ECR) is a well-known and rather frequently met condition, the driving force of this phenomenon still remains unclear. Recently, hypoxia has been linked to ECR. Thus, the aim of this work was to investigate the existence of hypoxia in ECR and hypothesize on its role at the time of extraction.This work is a case study of a tooth with ECR. ECR diagnosis was based on clinical and radiographic examination with cone-beam computed tomographic imaging. The extracted tooth was further analyzed by using nanofocus computed tomographic imaging and immunohistology. To investigate the 3-dimensional extent and pattern of ECR, in vivo cone-beam computed tomographic imaging and ex vivo nanofocus computed tomographic imaging were used. Different histologic stains were used to investigate the presence of a hypoxic environment and to gain a better insight into the involved cells, neuronal structures, and remodeling process during ECR.A higher distribution of hypoxia-inducible factor 1a–positive cells was found in the apical part of the resorption area when compared with the coronal area of the resorption. In addition, a similar distribution of hypoxia-inducible factor 1a–positive odontoblasts was observed in the pulp. Three-dimensional analysis of the calcification of the pulp revealed the formation of pulp stones in areas with higher hypoxia. Histology showed that remodeling during ECR can occur according to a layered pattern.This investigation confirms the presence of hypoxia in ECR and shows that there is a gradient of hypoxia within the ECR lesion and surrounding tooth structure. The hypoxic environment within the pulp is also indicated by the formation of pulp stones.

Nonsurgical Management of Periapical Lesion with External Root Resorption Followed by Orthodontic Treatment in Maxillary Lateral Incisor

The aim of this case report is to discuss the radiological outcome of a nonsurgical management of periapical lesion with external resorption followed by orthodontic treatment of the maxillary lateral incisor. A 33-year-old female reported with missing tooth in the maxillary anterior region as a result of surgical extraction of maxillary left canine tooth. Patient was referred for intentional root canal treatment in 22 followed by fixed prosthesis. The radiograph revealed external resorption in 21 and 22. After preparation of the access cavity, the necrotic pulp was removed and the canal irrigated using 5.25% sodium hypochlorite solution. The canal was then dried and packed with calcium hydroxide for 6 weeks. After removal of calcium hydroxide, canal was disinfected, dried and four millimetres of MTA orthograde filling was carried out. After 24 hrs, root canal was obturated with back fill using system B. At 1-3-6, month recall, the tooth was asymptomatic with no pain on percussion or palpation. Radiographic examination demonstrated continued thickening of root canal walls, root lengthening and apical closure.

Diagnosis and Management of Multiple External Inflammatory Root Resorption of Maxillary Central Incisor Using Cone Beam Computed Tomography-A Case Report

Avulsion and replantation of the teeth following traumatic injury causes complication such as inflammatory and replacement resorption. This case report describes a traumatic injury to the permanent maxillary central incisor exhibited pulpal necrosis leading to periapical cyst with massive bone loss and extensive external inflammatory root resorption. Endodontic therapy and surgery was performed to salvage the tooth with poor prognosis. The multiple resorptive defects were debrided and restored with resin modified glass ionomer cement. The postoperative follow-up revealed improved healing. The prognosis of the tooth which was badly destructed due to external inflammatory resorption was greatly enhanced with appropriate treatment plan and ultimately increased the longevity of the tooth.

Management of internal and external resorption with open apex

Tooth resorption is a phenomenon resulting in the loss of tooth structure. A simultaneous occurrence of internal resorption and communicating external resorption is often challenging for a clinician. To elicit immediate root canal treatment is of utmost importance, followed by the repair of defect to achieve promising results. For successful outcome, thorough investigations and obtaining a three-dimensional view of the extent and location of resorption should be obtained in order to plan the treatment.

A Comparative Evaluation of Five Obturation Techniques in the Management of Simulated Internal Resorptive Cavities: An Ex Vivo Study.

Background:Root resorption is the loss of dental hard tissues as a result of clastic activities. It might be broadly classified into external or internal resorption by the location of the resorption in relation to the root surface. the various techniques used these days for filling internal resorption include warm condensation, vertical condensation, core techniques, thermoplasticized gutta-percha, warm vertical compaction, and cold lateral condensation.Objectives:The aims and objectives of this study were to compare the quality of root fillings in artificially created internal resorption cavities filled with warm vertical compaction, lateral condensation, Obtura II along with System B, E and Q plus along with System B, and Thermafil, and to calculate the percentage of gutta-percha, sealer, and voids using an ImageJ software.Results:Results between the warm vertical compaction (group I), lateral condensation (group II), Obtura II with System B (group III), E and Q plus with System B (group IV), and Thermafil (group V), group III showed the highest percentage of gutta-percha plus sealer and gutta-percha, and least number of voids, which was statistically significant (P < 0.000).Conclusion:It can be concluded that Obtura II along with System B was found to be the most suitable obturation technique for the management of teeth exhibiting internal resorption. Thermafil was found to give the poorest obturation quality when used to fill the teeth with internal resorption. Similarly, lateral condensation technique was observed to show maximum sealer and hence was not ideal for the management of internal resorptive cavities.

Decoronation of Ankylosed Incisors in Two Adolescent Patients

Avulsion of permanent dentition represents a serious if relatively uncommon type of traumatic injury. The most frequent complication after replantation of teeth is ankylosis, from initial root resorption through eventual replacement of lost root substance with bone. Decoronation may be considered an alternative treatment strategy for ankylosed incisors in young patients. In the two cases reported on here, ankylosed teeth in adolescent patients were decoronated and prosthetically restored after late and less-than-ideal replantation procedures. The results obtained in these two cases are indications that d ecoronation may be a good treatment option for teeth affected by replacement and external resorption in young people who have not yet completed their growth and development.

Effects of root canal irrigations on intracanal medication with calcium hydroxide effects in root external resorption models

ObjectiveThe objective of the present in vitro study was to evaluate the influence of endodontic irrigation systems on the removal of smear layer and ion diffusion of calcium hydroxide through dentinal tubules in root external resorption models. Materials and methodsForty single-rooted teeth were divided into four groups (G1, G2, G3, and G4) according to the irrigation regimens: G1, saline solution; G2, 10% sodium hypochlorite with ultrasonic irrigation; G3, 14% EDTA with ultrasonic irrigation; G4, 14% EDTA with ultrasonic irrigation → 10% sodium hypochlorite with ultrasonic irrigation. Ultrasonic irrigation lasted 45 seconds and all the roots were irrigated with 2 mL of saline solution. In experiment 1, the samples were observed on the root canal wall using scanning electron microscope and the percentage of opened dentinal tubules (POD) was calculated. Experiment 2 evaluated the diffusion of calcium ions through dentinal tubules. ResultsIn the middle region of root canals, the mean POD values were 0.11, 5.02, 82.17 and 96.72 in G1, G2, G3, and G4, respectively. In the apical region of root canals, the mean POD values were 0.06, 0.43, 4.41, and 12.70 in G1, G2, G3, and G4, respectively. The diffusion of calcium ions in G4 was significantly high in all groups. ConclusionThis study demonstrated that a combination of EDTA and sodium hypochlorite with ultrasonic irrigation was most effective in removing the smear layer and ion diffusion from the root canal to the surrounding media.

Long‐term retention of avulsed maxillary permanent incisors replanted after prolonged non‐physiological storage

Ankylosis and external replacement resorption (ERR) are two typical biological responses to delayed replantation of avulsed teeth in cases where adequate root canal treatment is performed. The patient's growth stage affects the progression of root resorption and the long-term outcome of the affected teeth. This case report describes the long-term outcome of an 18.5-year-old patient following an accident in which both of his maxillary central incisors were avulsed and replanted after four hours of non-physiological storage. ERR and ankylosis of teeth 11 and 21 were detected clinically and radiographically during the second year of follow-up. Sixteen years after replantation, replacement resorption was progressing very slowly, enabling functional tooth retention with favorable esthetics. Young adults, with delayed replantation of avulsed teeth, may benefit from tooth retention with slow ERR.

European Society of Endodontology position statement: External Cervical Resorption.

This Position Statement represents the consensus of an expert committee convened by the European Society of Endodontology (ESE) on External Cervical Resorption (ECR). The statement is based on current clinical and scientific evidence as well as the expertise of the committee. The primary aim is to provide a current authoritative position on the aetiology, histopathology, clinical presentation and management of ECR, and also to highlight areas where there is minimal evidence. Previously published review articles provide more detailed background information and the basis for this position statement (International Endodontic Journal 51, 1205, 2018, International Endodontic Journal 51, 1224, 2018). It is intended that this position statement will be updated at appropriate intervals, as further evidence emerges.

Invasive Cervical Resorption: Clinical Management in the Anterior Zone

According to the high number of articles published on invasive cervical resorption (ICR), this pathology, as commonly believed, is a more frequent form of cervical resorption. ICR is often misdiagnosed as internal resorption or caries, which leads to inappropriate treatment and even unnecessary tooth loss. Despite a correct diagnosis, the treatment of this type of hyperplastic invasive external resorption poses a challenge for the clinician. The Heithersay classification and the use of cone-beam computed tomographic imaging have increased our knowledge of the pathology and helped improve its prognosis. Nevertheless, there is no standard protocol for the treatment of this type of lesion. This article proposes a treatment protocol for ICR based on the pattern and location of resorption. Three treatment approaches (internal access, external access, and intentional replantation) are presented through 3 clinical cases.

BLANQUEAMIENTO DENTAL INTERNO. REPORTE DE UN CASO.

El cambio de color en los dientes no vitales, es una observación clínica muy frecuente, ocasionada por algunos factores. El objetivo del presente trabajo, es reportar un caso clínico, de paciente que presentó cambio de color en un diente no vital como resultado de la necrosis pulpar, cuya frecuencia de presentación es alta en dientes no vitales; el tratamiento de clareamiento suele ser difícil y a veces poco efectivo. Se un presenta paciente de sexo femenino, de 28 años de edad, referido a consulta odontológica para tratamiento endodòntico y blanqueamiento intracoronal en el incisivo laterals uperior derecho; con antecedente de traumatismo en el mencionado diente, a la inspección se observa cambio de coloración por necrosis pulpar, pruebas de sensibilidad pulpar negativas, al análisis radiológico presentó lesión periapical, diagnosticándose periodontitis apical crónica. El paciente recibió tratamiento de endodoncia del incisivo superior derecho, y se le realizó blanqueamiento interno utilizando como agente aclarador Endodondtic Whitening System (35% peróxido de hidrógeno), de la casa comercial Ultradent. Se realizó control clínico y radiológico a los 6 y 18 meses, observándose una adecuada evolución clínica; al análisis radiológico se observa reparación ósea de la lesión y a nivel cervical ningún dato que evidencie reabsorción externa cervical.

External invasive resorption: Possible coexisting factors and demographic and clinical characteristics.

The purpose of this retrospective study was to identify the coexisting factors for EIR and to characterise EIR clinically and demographically. All cases of EIR that were referred to the endodontic department between 2011 to 2016 and diagnosed by an endodontist were evaluated. Demographic and clinical characteristics were collected and evaluated. Thirty-eight cases of EIR diagnosed between 2011 and 2016 were included in the study. Seventy-one percent of EIR cases were misdiagnosed by general practitioners. The most affected teeth were the maxillary central incisors (29% of cases) and mandibular molars (26%). Sixty-eight percent of EIR cases were diagnosed in teeth with clinically normal pulp. Pulp necrosis was observed mainly in the advanced stages (class 3 and class 4) of EIR (75%) and in teeth with a history of trauma (63%). Histories of previous trauma and orthodontic treatment were reported in 29% and 23% of cases, respectively.

Oral and dental anomalies in purebred, brachycephalic Persian and Exotic cats.

OBJECTIVE To determine the prevalence of dental anomalies in brachycephalic cats from various geographic regions and analyze potential relationships with oral disease. DESIGN Prospective multicenter cross-sectional study. ANIMALS 50 purebred Persian (n = 42) and Exotic (8) cats. PROCEDURES Cats were anesthetized, and a complete dental examination, dental charting, 3-view oral photography, and full-mouth dental radiography were performed. RESULTS Malocclusions were observed in 36 (72%) cats. Crowding of the teeth was evident in 28 (56%) cats, with the incisors being most commonly affected. Malpositioned teeth were noted in 32 (64%) cats, with abnormal orientation being the most common anomaly followed by rotation and impaction. Numerical abnormalities were present in 38 (76%) cats, including 6 (12%) with hyperdontia and 32 (64%) with hypodontia. Periodontal disease was reported in 44 (88%) cats, and cats with periodontal disease were older than cats without. Tooth resorption was evident in 35 (70%) cats. Overall, 123 of 1,349 (8.7%) teeth had external inflammatory resorption and 82 (6.1%) had external replacement resorption. The premolar teeth were the teeth most commonly affected with inflammatory resorption, whereas the canine teeth were the teeth most commonly affected with replacement resorption. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that because of their brachycephaly, Persian and Exotic cats have unique oral and dental features that may predispose them to dental disease (eg, tooth resorption and periodontal disease). Knowledge of the particular dental anomalies common in brachycephalic cats could aid in early detection and mitigation of dental disease in these breeds.

Indications for extraction of permanent maxillary canines – a literature review

Orthodontic movement of a maxillary canine into the dental arch may be a therapeutic challenge, and it is necessary to analyse a case in detail and to evaluate therapeutic methods, including a difficult decision of tooth extraction in all cases.&lt;b&gt; Aim&lt;/b&gt;. The paper aims to discuss orthodontic indications for maxillary canine extraction based on available literature. &lt;b&gt;Material and methods&lt;/b&gt;. The PubMed database and the following key words were used for studies: canine impaction, maxillary impacted canine and canine extraction. Literature was supplemented with publications from reviewed journals not included in the PubMed database. 50 papers were selected from the literature list. &lt;b&gt;Results, review and discussion&lt;/b&gt;. A decision to extract a maxillary canine should be made based on a detailed clinical examination and analysis of orthodontic records, including photographs, diagnostic models and radiological scans. CBCT imaging test should be performed as standard before treatment in case of impaired tooth eruption. Factors that should be especially considered include: tooth anatomy, periodontal status, position in the bone, occlusion, condition of the adjacent teeth and any pathological processes in the tooth vicinity. Before making a therapeutic decision a patient should be informed about available therapeutic options according to current medical knowledge, as well as about advantages and disadvantages of each of them. &lt;b&gt;Summary&lt;/b&gt;. Factors favouring extraction of impacted canines or canines with impaired eruption include: unfavourable position (a horizontal position of a tooth in the bone, position in the zone IV and V according to Kurol, large distance from the edge of the alveolar process), anatomical abnormality (root angulation, external or internal resorption), root ankylosis, patient’s age above 30 years and good occlusion without a canine in the dental arch with the need to extract a premolar for its movement into the dental arch. &lt;b&gt;(Baszak J, Sobieszczańska A, Dunin-Wilczyńska I. Indications for extraction of permanent maxillary canines – a literature review. Orthod Forum 2018; 14: 130-42)&lt;/b&gt;.

DENTAL ROOT RESORPTION. ANALYSIS OF DIAGNOSTICS AND TREATMENT ALGORITHMS USED IN PRACTICE

Resorption of the root of the tooth is a process in which the hard tissues of the tooth and the surrounding bone are destroyed. The incidence of internal resorption is unknown, because the results may vary significantly when different diagnostic methods are used. Scientific publications focus on external resorption, but internal resorption is also a problem for the practitioner. This article describes the results of an anonymous questionnaire of doctors with the purpose of analyzing knowledge about root resorption and internal resorption in particular.