Internal Inflammatory Resorption Research Articles

The role of infection in signalling root resorption: Anarrative review.

Root resorption consists of complex, multistep processes that involve cell signalling caused by inflammation and stromal cells, which promotes the secretion of receptor activator of nuclear factor κB ligand/ macrophage-colony stimulating factor (RANKL/M-CSF) resulting in a resorptive process. The aim of this narrative review was to analyse the literature related to root resorption resulting from microbial infection and to comparing it with non-microbial infection. An electronic literature search was performed using the PubMed database and applying keywords of articles published in English. Eligible papers were reviewed to reveal the descriptions of bone and root resorption processes. The abstracts were searched manually to identify articles about infection-stimulating bone and root resorption. Three main types of root resorption were identified, two associated with primary bacterial infection and one secondary to bacterial infection. These include external inflammatory resorption, internal inflammatory resorption and external cervical (invasive) resorption. The magnitude of cytokine involvement that promotes resorption and M-CSF/RANKL production depends on multiple factors, including pathogen virulence, site of infection and host genetic factors that activate the inflammation at the infection site. Two mechanisms activate the resorption mechanisms-the canonical and non-canonical pathways that can activate clastic cells independently of the RANKL/RANK canonical pathways. Two pathways of root resorption co-exist in the body. When resorption is caused by infection, chronic inflammation due to bacterial infection prolongs the secretions of pro-inflammatory cytokines that intensify root and bone resorption. The second pathway is bacterial independent of the non-infection root resorption that is part of the wound healing process, which is limited in time due to its innate ability.

Intraoral Radiographic Interpretation Agreement Between Veterinary Students, Veterinary Dental Residents and Veterinary Dental Specialists.

This study evaluated observer variations in the interpretation of radiographic evidence for periodontal disease, tooth resorption, and endodontic disease in dogs. Forty dental radiographs were evaluated for 12 different parameters (periapical destruction of bone, wider than expected root canal, narrower than expected root canal, apical root resorption, loss of alveolar bone, external surface resorption, external replacement resorption, external inflammatory resorption, external cervical root resorption, internal surface resorption, internal replacement resorption, internal inflammatory resorption). Interpretations by 20 veterinary dentists, 10 veterinary dental residents, and 10 veterinary students were analyzed for consistency within groups and between groups by intraclass correlation coefficients (ICCs [95% CI]). Additionally, the agreement rate between groups compared to histopathological diagnosis, when available, and to a consensus group were evaluated. The results showed fair to good interobserver agreement for all participants when looking at all questions simultaneously (0.578 [0.515-0.635]) and with the consensus group (0.483 [0.451-0.517]). However, questions pertaining to various types of tooth resorption scored the lowest ICCs ranging from 0.005 (-0.311 to 0.321) to 0.189 (-0.105 to 0.402) across individual groups. Students had the lowest agreement compared to the consensus group for all questions (0.383 [0.347-0.421]) with fair to good agreement involving groups of residents (0.501 [0.465-0.538]), recently boarded diplomates (0.541 [0.506-0.578]), and more experienced diplomates (0.545 [0.510-0.582]). While dental radiographs are essential for clinical decision making, this study shows that interpretation of radiographs is highly subjective.

Pattern of Root Resorption in Luxation Injuries in Permanent Incisors Presented to Restorative Unit , Institute of Oral Health, Maharagama – Sri Lanka

The aim of this descriptive study was to evaluate the association between root resorption and each type of luxation injury, the effect of timely treatment, age of the patient at presentation and maturity of maxillary anterior teeth presented with luxation injuries. A cross sectional descriptive study was carried out on 132 patients aged 6 to 50 years old with luxation injuries occurred to 213 teeth and were followed up for 24 months. Data were collected on the age, sex, the tooth/teeth involved, type of trauma, date of occurrence of trauma and date of presentation for treatment. Radiographically teeth were assessed for the presence/absence of resorption and type of resorption (External inflammatory, external replacement and Internal inflammatory) at review appointments. Data analysis was done using the SPSS version- 24 and non- parametric tests were used assess associations. Amongst all types of luxation injuries, most frequently presented type was subluxation (40.8%) injuries followed by concussion (25.4%), Intrusive and palatal luxation (15.5% each) and extrusive luxation (2.8%) respectively. Further, 51 of 213 teeth (23.9%) showed root resorption after luxation injury. The most frequently observed resorption was external inflammatory resorption in 44 teeth (20.7%) followed by external replacement resorption in 6 teeth (2.8%) and internal inflammatory resorption in 1 tooth (0.5%). Out of 43 late presenters 77% (34) showed root resorption, while only 10% (17) of immediate presenters showed resorption of root. The results indicated that there is a statistically significant difference in occurrence of root resorption and the late presentation for treatment (X2=91.63, df=3, p=0.000), as well as with the type of injury (X2=35.9, df=12, p=0.000). Furthermore, there was a statistically significant difference between the age of the patient and the type of luxation injury (X2 =54.29, df-12, P=0.000).

Non-Surgical Management of an Anterior Tooth with Internal Inflammatory Resorption: A Case Report

Background: According to the Glossary of the American Association of Endodontists, resorption is definedas a condition associated with either a physiologic or a pathologic process resulting in the loss of dentin,cementum, or bone. It may present internally (pulpal origin) or externally (periodontal origin). Internalresorption is a rare, insidious, resorptive pathological process, starting from the pulp extending into thesurrounding dentin. Treatment is mainly focused on arresting the cellular activity accounting for theresorptive process.Methodology: A patient presented with an upper front tooth that was tender on percussion and a history oftrauma in her childhood which resulted in Ellis class II fracture of the tooth. Pulp sensibility testing showeda negative response suggestive of a non-vital tooth. A non-surgical endodontic therapy was carried out underthe microscope with calcium hydroxide dressings followed by the three-dimensional obturation techniqueusing thermoplasticized Gutta percha.Conclusion: The current case report discusses the etiology and symptoms of internal inflammatoryresorption, the contribution of cone beam computed tomography imaging in its diagnosis, and a step wiseprotocol for the three dimensional obturation of the resorptive lesion.

Reparative Endodontic Treatment of a Perforating Internal Inflammatory Root Resorption: A Case Report

The aim of this case report was to present a reparative treatment approach of an extensive internal inflammatory resorption with a lateral perforation and apical and lateral inflammatory lesions. Only the necrotic coronal part of the pulp was removed, and the vital pulp tissue within the resorption cavity and the apical part of the root canal was left uninstrumented. Bleeding was induced, and the blood clot was covered with mineral trioxide aggregate. Hard tissue repair and healing of the apical lesion could be observed in the 3-year recall.

Endodontic management of internal inflammatory resorption

Management of internal resorptive defects are always a challenge for an endodontist. Internal resorption occurs mostly commonly due to trauma or a long stand chronic pulpal irritation following caries or trauma and is most commonly seen in the anterior teeth and sometimes in the posterior teeth as well. Early diagnosis and removal of underlying pathology are important for long-term success. The case paper reports nonsurgical management of a case of internal inflammatory resorption treated by root canal therapy followed by obturation with thermoplasticized gutta-percha.

Pulp pathosis in inlayed teeth of the ancient Mayas: a microcomputed tomography study

To evaluate three-dimensionally, using microcomputed tomography (μCT), the anatomical relationship between the cavity prepared to hold the inlay stone and the pulp chamber in the teeth of the ancient Maya. Six well-preserved teeth from Maya corpses found in an archaeological site in Guatemala (approximately 1600 year old) were selected and scanned using a high-resolution μCT system (SkyScan 1174v2; SkyScan N.V., Kontich, Belgium). The sample comprised six maxillary teeth: two canines, one premolar, two central incisors and one lateral incisor. All teeth had one or two inlay stones on the buccal surface of the crown. Each specimen was scanned at an isotropic resolution of 22.5 μm, a rotational step of 0.70°, a rotational angle of 180° and a 3.1-s exposure time, using a 1-mm-thick aluminium filter. Images of each specimen were reconstructed from apex to the crown with dedicated software (NRecon v1.6.1.5) in approximately 450 slices. CTan v1.11 and CTVol v2.1 were used for three-dimensional visualization and qualitative analysis of the external and internal anatomy of the teeth. The tooth modification in all samples was classified as type E1 (one stone on the buccal surface of the crown) or E2 (two stones on the buccal surface of the crown). In the canine teeth, the cavities created to insert the inlay stone did not reach the pulp chamber. Conversely, in the maxillary incisors, the cavities clearly perforated the pulp chamber resulting in massive internal inflammatory resorption or partial calcification of the pulp cavity. In the premolar tooth, a small perforation of the pulp chamber under the buccal cusp, without morphological alteration of the intraradicular dentine, was observed. Microcomputed tomography analysis of teeth of the ancient Maya civilization showed that the inlay cavities cut reached the pulp chamber in the maxillary incisors and premolar teeth, with the potential to cause pulp and periapical disease.

Teeth with double internal inflammatory resorption: Report of two cases

Internal inflammatory resorption is an uncommon condition, which requires the presence of necrotic and infected pulp tissue within the coronal portion of the root canal system as well as inflamed pulp tissue apical to the resorptive defect. The defect usually appears as a bowl-shaped radiolucency within the tooth root. Most cases are asymptomatic and many cases are only seen once the entire pulp has necrosed and all of the root canal system is infected resulting in apical periodontitis. The two cases presented are unusual in that they both had two distinct areas of internal inflammatory resorption. It is hypothesised that the more coronal lesion occurred first and then it ceased to continue resorbing the root in that position as the 'necrotic, infected front' moved apically at which time a second resorptive defect developed. The management, using different approaches, of these two cases of 'double internal inflammatory resorption' is described.

Radiographic evaluation of the types of tooth resorption in dogs

To determine the prevalence of tooth resorption in dogs and to evaluate whether a classification system for tooth resorption in humans is applicable in this species. 224 dogs > 1 year old admitted for periodontal treatment or other dental procedures in 2007. Full-mouth radiographs of all dogs were reviewed for evidence of tooth resorption. Tooth resorption was classified in accordance with radiographic criteria described for use in humans. Patient signals and concurrent dental conditions were recorded and tabulated. Tooth resorption was detected in 120 of 224 (53.6%) dogs and 943 of 8,478 (11.1%) teeth. The classification system for use in humans was applicable in 908 of 943 (96.3%) affected teeth. Tooth resorption was more frequent among older and large-breed dogs; no significant differences were found among sex categories. The 2 most common types of tooth resorption were external replacement resorption (77/224 [34.4%] dogs and 736/8,478 [8.7%] teeth) and external inflammatory resorption (58/224 [25.9%] dogs and 121/8,478 [1.4%] teeth). External cervical root surface resorption was detected in 13 of 224 (5.8%) dogs; external surface resorption was detected in 10 of 224 (4.5%) dogs, and internal inflammatory resorption and internal surface resorption were detected in 9 of 224 (4.0%) and 1 of 224 (0.4%) dogs, respectively. Internal replacement resorption was not detected. The classification of tooth resorption in humans was applicable to tooth resorption in dogs. Resorption lesions, in general, and external replacement and external inflammatory resorption, in particular, were frequently detected in dogs.