Internal Root Resorption Research Articles

Endodontic management of a tooth with internal root resorption

Endodontic management of a tooth with internal root resorption

Evaluation of different irrigation activation techniques for the removal of various medicaments from a simulated internal resorption cavity: an in vitro study.

This study aimed to assess the efficacy of different activation techniques in removing calcium hydroxide (Ultracal XS), Ledermix, and Bio-C Temp from simulated internal root resorption (IRR) cavities. 108 single-rooted maxillary incisors were prepared using Reciproc R50 files. Simulated IRR cavities, 2mm in diameter and located 8mm from the apex, were created. Ultracal XS, Ledermix, and Bio-C Temp were applied to the samples, grouped by irrigation activation techniques: Standard Needle Irrigation (SNI), EDDY, Passive Ultrasonic Irrigation (PUI), and XP-endo Finisher (XPF). Medicament removal efficacy was evaluated using a standardized scoring system. Statistical analysis was performed using the Kruskal-Wallis test. XPF and PUI were more effective than SNI in medicament removal across the groups, with no significant difference. EDDY showed no significant difference than other groups. Ledermix was more effectively removed in all activation groups compared to Bio-C Temp. The XPF was superior in removing Ultracal XS compared to Bio-C Temp. However, none of the groups achieved complete medicament removal. XPF and PUI techniques enhance medicament removal efficacy. Bio-C Temp was more difficult to remove from the IRR cavities than other medicaments. Bio-C Temp could be removed from the canals less effectively compared to calcium hydroxide and Ledermix. Among the tested irrigation activation methods, XPF and PUI were found to be more effective at removing the tested medicaments.

Evaluation of the efficacy of different irrigation activation techniques in removing of calcium hydroxide on teeth with the simulated internal root resorption cavity: a confocal laser scanning microscope analysis.

The aim of this study is to evaluate the effect of different irrigation activation methods on root canal sealer penetration in teeth with simulated internal root resorption (IRR) and calcium hydroxide (CH) applied using a confocal laser scanning microscope (CLSM). 60 incisors with a single root and a single canal were included in the study. IRR cavities were created in the middle third of the root canal, and CH was placed. The samples were randomly divided into 4 groups (n = 15) according to the irrigation activation method to be tested: standard needle irrigation (SNI), sonic activation (EDDY), photon-induced photoacoustic flow (PIPS), and shock wave enhanced emission photoacoustic flow (SWEEPS). After irrigation activation applications, the root canals were obturated. Sections of 1.0 ± 0.1mm were taken from the apical, middle, and coronal regions of each sample. The penetration area (µm2) and maximum penetration depth (µm) of the root canal sealer were examined by CLSM and analyzed using ImageJ software. Statistical analysis was performed with a one-way ANOVA and post-hoc Tukey test at the P < 0.05 significance level. Among all irrigation activation methods tested, both the penetration area and maximum penetration depth of the root canal sealer were greater in the coronal region than in the apical region (p < 0.05). In the IRR region, there was no difference in terms of maximum penetration depth between PIPS and SWEEPS (p > 0.05), it was highest in SWEEPS (p < 0.05). PIPS and SWEEPS were better than other irrigation activation methods in the penetration of root canal sealer in the resorption areas of teeth with IRR.

Quality of different obturation techniques to fill perforating internal root resorption: a micro-computed tomographic study

BackgroundThis study aimed to assess the quality of various obturation techniques to fill perforation caused by internal root resorption using Micro-computed Tomography.MethodsCone-beam computed tomography images of a maxillary central incisor tooth with perforating internal resorptive defect were used to create a 3D printed model of the affected tooth. The replicas were divided into four groups based on the obturation technique used. The techniques included Group 1: a polydimethylsiloxane-based sealer (GuttaFlow-2) with gutta-percha. Group 2: same as Group 1 except for using a pre-mixed Bioceramic-based sealer (NeoSEALER Flo). Group 3: the defect was filled entirely using the NeoSealer Flo Bioceramic-based sealer. Group 4: the samples were obturated using the warm vertical compaction technique with a resin-based sealer (ADSeal). The resin models were then scanned a micro-computed scanner to evaluate the percentage of voids in each group.ResultsThe results showed that NeoSEALER Flo groups had significantly the highest volume of voids while GuttaFlow-2 and warm vertical compaction groups had the lowest void volume.ConclusionsGuttaFlow-2 and warm vertical compaction techniques performed best in filling the internal resorptive defect.

Management of internal root resorption with perforation and periapical cyst in permanent teeth: A case report

Management of internal root resorption with perforation and periapical cyst in permanent teeth: A case report

Management of rarely seen internal tunnelling root resorption associated with a maxillary permanent incisor

This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little published literature.A 25-year-old woman was referred to a specialist centre by her general dental practitioner following an incidental finding of a radiographic radiolucency, suggestive of root resorption associated with tooth 21. A provisional diagnosis of external cervical resorption was made, and following cone beam computed tomography (CBCT), a definitive diagnosis of internal tunnelling root resorption given. Non-surgical endodontic treatment was completed using continuous wave compaction with a calcium-silicate based sealer. No further intervention has been required.A summary of the histology, aetiology, prevalence, diagnosis, management and prognosis of internal tunnelling root resorption is provided. The benefits of CBCT for diagnosing and managing internal tunnelling resorption defects and using continuous wave compaction with a calcium-silicate based sealer, compared to cold obturation techniques, are discussed.

Non-surgical management of simultaneous occurrence of internal root resorption and calcific metamorphosis: A case report

Internal resorption and calcific metamorphosis are two sequelae of pulpal necrosis after traumatic injuries like concussion and luxation injuries. After traumatic injury, the pulp may become completely necrosed followed by calcification of the entire root canal by the activity of odontoblastic cells. In some other cases, partial necrosis of the pulp tissue with overstimulation of odontoclastic cells and resorption of the root canal dentinal walls may happened. Commonly any of the cells become active and one of the sequelae may will continue. Rarely these two conditions will happen together. In this particular case report with simultaneous occurrence of these two conditions with symptomatic periapical abscess.

Long-Term Evaluation of Tooth Transplantation: An Umbrella Review.

Aim/Objective: This umbrella review of systematic reviews aims to summarize the available data regarding both success and survival rates of tooth autotransplantation, in addition to analyzing the risk factors that are connected to those rates. Methods: This umbrella review was performed according to the evaluation of various meta-analyses and systematic reviews following AMSTAR2 guidelines. A systematic search of literature on PubMed, Scopus, MEDLINE, EMBASE, and the Cochrane Database. Six systematic reviews were included. Explicit inclusion and exclusion criteria were applied. It is registered in PROSPERO under the registration number (CRD-42023415623). Results: The studies reviewed were written from 2014 to 2018, which extracted the information from various studies spanning from 1968 to 2014. According to the selected studies regarding autotransplanted teeth in humans, they showed the following: A survival rate overall of 87.39% and a success rate overall of 90.29%. These factors were the most common in relation to the success of the autotransplanted teeth: age, gender, and stage of root development. On the other hand, common unfavorable results linked to the transplanted teeth in these studies were failure, ankylosis, and internal root resorption, followed by extraction and hypermobility. Conclusions: The wide body of evidence gathered illustrates that autotransplantation is an operation that dispenses high rates of survival and success. Furthermore, risk factors like root development stage, recipient site, and donor tooth type established a remarkable association with the negative outcomes of the procedure. For successful tooth autotransplantation, patient selection is crucial. Younger patients and those with donor teeth at an optimal stage of root development typically experience better outcomes. Preoperative planning should include comprehensive evaluations and advanced imaging techniques to accurately assess both the donor tooth and the recipient site. Nonetheless, on account of heterogeneity and the quality of the studies included in this investigation, caution should be taken when interpreting the mentioned results.

Comparative Effectiveness of Different Er:YAG Laser-Activated Irrigation Systems on Removing Calcium Hydroxide from Simulated Internal Root Resorption Cavities at Different Root Levels.

Objective: To investigate the effectiveness of Er:YAG laser-activated irrigation (LAI) with a short pulse duration for removing calcium hydroxide (CH) from simulated internal root resorption (IRR) cavities at three root levels. Background: Pulse duration is an important parameter during LAI, which ensures the efficiency of irradiation and the corresponding activation process. Short pulses in the range of a few microseconds enable rapid expansion and successive implosion of irrigants, resulting in distinct fluid movement. There have been few reports on CH removal efficacy from IRR cavities of different LAI systems, including those using short pulse duration. Methods: IRR cavities (1.6 mm diameter) were created at the apical, middle, and coronal root levels in 60 mandibular premolars and filled with a radiopaque CH paste. Samples were assigned to the following irrigation groups (n = 12, each): (1) LAI(P)-F, a prototype laser device that operates with short pulse duration (Morita Manufacturing) with a flat tip; (2) LAI(EA)-F, the ErwinAdverl laser device (Morita Manufacturing) with a flat tip; (3) LAI(EA)-T, the ErwinAdverl laser device with a tapered tip; (4) PIPS-T, the Lightwalker laser device (Fotona) with a tapered tip; and (5) SI, the syringe irrigation group. The laser tips were fixed at the canal entrance. The remaining CH volume and surface area were assessed in IRR cavities using micro-computed tomography and scanning electron microscopy, respectively. Data were statistically analyzed utilizing one-way analysis of variance and Tukey's test at 5% significance level. Results: The LAI(P)-F and PIPS-T groups exhibited the highest CH removal rates at three different levels (p < 0.05). The LAI(EA)-F group had a significantly better efficacy of CH removal compared with the LAI(EA)-T group at the middle level (p < 0.05). Conclusion: The LAI(P)-F and PIPS-T groups demonstrated superior efficiency in removing CH from simulated IRR cavities.

Three-Dimensional Measurement of Obturation Quality of Bioceramic Materials in Filling Artificial Internal Root Resorption Cavities Using Different Obturation Techniques: An In Vitro Comparative Study

IntroductionPathologic conditions such as internal root resorption (IRR) may complicate root canal filling. This study aimed to evaluate and compare the obturation quality by measuring the percentage of obturation volume (POV) in root canals with artificial IRR obturated with different materials and techniques using cone beam computed tomography (CBCT). MethodsForty single canal extracted mandibular premolars were decoronated to standardize their length to 14 mm. Following instrumentation, the roots were cut horizontally, and artificial IRR cavities were made at the level of 7 mm from the apex. The root halves were joined using cyanoacrylate adhesive. The samples were randomly assigned to 4 groups (n = 10), and the canals were filled as follows: single-cone technique (SC), bulk-fill Bio-C Sealer (BF), and Bio-C Repair for the coronal and middle third (BCR) + cold lateral condensation technique (CLC) for the apical third and continuous wave compaction technique (CWC). The pre- and postobturation volumes and the POV were measured in the total canal and for the apical, middle, and coronal thirds separately using CBCT and Mimics Medical software. The results were analyzed statistically using one-way ANOVA and Tukey HSD test, and statistical significance was set at P < .05. ResultsBF group resulted in significantly lower total, coronal, middle and apical POV values compared to SC, BCR + CLC, and CWC groups (P < .05), respectively. Also, at the apical third, the BCR + CLC group showed significantly lower POV than the SC and CWC groups (P < .05), respectively. The intra-group comparison showed that BF and BCR + CLC groups had a significantly lower POV in the apical third compared to the middle third (P < .05). Conversely, the CWC group had a significantly higher apical POV than the middle third (P < .05). ConclusionsThe maximum POV was obtained using the CWC technique, Bio-C Repair, and SC technique with Bio-C Sealer, making their application in IRR more preferable than the BF Bio-C Sealer.

Epoxy vs. Calcium Silicate-Based Root Canal Sealers for Different Clinical Scenarios: A Narrative Review.

This study aimed to review the considerations for choosing a suitable sealer according to various endodontic scenarios. An electronic search of PubMed, Scopus, and the Web of Science was undertaken for the keywords of 'sealer choosing', 'appropriate sealer', 'suitable sealer', 'sealer for clinical scenario', and 'sealer for clinical situations'. However, the literature review revealed a lack of studies with practical clinical recommendations regarding the choice of appropriate endodontic root canal sealers for particular clinical situations of root canal treatment. Therefore, a narrative review was undertaken under the basis of the characteristics of an epoxy resin-based sealer (ERS) versus a calcium silicate-based sealer (CSS). Based on the evidence found through the review, the choice of an appropriate sealer in a variety of clinical scenarios was proposed. An ERS is recommended for one-visit non-vital cases, teeth with periodontal involvement, cracked teeth, and internal root resorption without root perforation. A CSS is recommended for vital or non-vital cases in multiple visits, teeth with internal root resorption with perforation or internal approach for external cervical resorption, teeth with open apices, and teeth with iatrogenic aberrations.

RADIOLOGICAL ASSESSMENT OF THE PREVALENCE AND LOCATION OF ROOT RESORPTION IN EPILEPTIC PATIENTS: AN OBSERVATIONAL STUDY

Objective: Antiepileptic drugs used in the treatment of epilepsy patients have a negative effect on bone tissue, but as far as we know, tooth root resorption has not been investigated in these patients. The aim of this study was to evaluate the prevalence of external and internal root resorption and its distribution according to resorption sites in epilepsy patients using antiepileptic drugs.&#x0D; Material and Methods: Panoramic radiographs obtained before dental treatment were evaluated. While the case group consisted of only those with epilepsy, the control group included healthy subjects. The presence/absence of external and internal resorption of all teeth (except the third molars), region of resorption (cervical, middle, and apical region of the root), age, and sex were recorded in an excel file. Independent sample t-test or Mann-Whitney U test according to normality of distribution and a chi-square test to compare categorical variables were used. &#x0D; Results: The resorption in 93 (21.9%) of 424 patients (236 healthy subjects and 188 epileptic patients), the groups did not significantly differ by the presence of external and internal resorption (p = 0.089 and 0.746). It was more common in those over 30 years and males (p = 0.018 and 0.013).&#x0D; Conclusion: We concluded that the presence of resorption in epilepsy patients was not different from healthy subjects. However, in patients with epilepsy, resorption was mostly seen in the lower molars and middle 1/3 regions. Clinicians should consider our results when treating these patients.

Histological Evaluation of Internal Dental Resorption: An Analysis of a Cohort of 50 Cases.

This study aimed to perform a histological evaluation of teeth diagnosed with internal root resorption. A descriptive study involved the examination of 50 human teeth extracted due to an unfavorable prognosis for retention in the oral cavity. Teeth were preserved in 10% buffered formalin and subsequently subjected to the decalcification process. Masson-Goldner staining was applied for comprehensive histological assessment. In all the 50 teeth examined, resorption gaps within the dentin tissue were identified, accompanied by the presence of reparative cells in the vicinity of these cavities. Marked structural loss and dentin fragmentation were evident, with regions exhibiting fissures and an absence of dentinal tubules. The histological evaluation of 50 teeth diagnosed with internal dental resorption revealed significant structural alterations, including resorption lacunae, the presence of multinucleated osteoclast-like cells, and reparative connective tissue. These findings highlight the complex and multifaceted nature of internal dental resorption. These histological insights provide a deeper understanding of the pathological processes involved in internal dental resorption and underscore the necessity for early detection and intervention to mitigate tooth loss and preserve dental health.

DIAGNOSIS OF INTERNAL ROOT RESORPTION: CLINICAL MANIFESTATIONS AND RADIOLOGICAL FEATURES

DIAGNOSIS OF INTERNAL ROOT RESORPTION: CLINICAL MANIFESTATIONS AND RADIOLOGICAL FEATURES

Treatment of Teeth with Root Resorptions: A Case Report and Systematic Review

Aim. This article presents an evaluation of different multidisciplinary treatment approaches to managing teeth with external and internal root resorptions.&#x0D; Methods. This study presents a clinical case of a 35-year-old female patient referred to Akdeniz University for dental issues. A comprehensive review of the literature was conducted, encompassing 21 articles sourced from PubMed and Web of Science over the past decade, including case reports and case series.&#x0D; Results. Case Report. A clinical case of a 35-year-old female patient seeking treatment for dental aesthetic concerns was reported and discussed. Intraoral examination revealed discoloration of maxillary anterior teeth and a sinus tract in the apical region of tooth #11. The resorption area was sealed with mineral trioxide aggregate. Afterward, the coronal part of the root was filled using the warm-vertical compaction method. During the final visit, non-vital bleaching was applied to teeth #11 and #21. After all these procedures, aesthetic coronal restorations were completed. Systematic Review. In the context of this clinical case, a literature review was conducted, encompassing an assessment of a total of 25 cases of external and internal resorptions. Among these cases, a combination of surgical and endodontic treatments was applied in 12 cases, while non-surgical endodontic treatment was performed in 13 cases.&#x0D; Conclusions. In the present case report, a patient who had both external and internal root resorptions was treated with mineral trioxide aggregate and flap operation, with no subsequent complications during the follow-up sessions. Among the 21 reports included in our review, 24 out of 25 treated teeth demonstrated successful outcomes, while only one tooth necessitated extraction.

Retrospective analysis of ferric sulfate and sodium hypochlorite pulpotomy procedures in primary molars.

Pulpotomy is a vital pulp treatment procedure frequently used in primary molars to preserve pulp vitality and function until tooth exfoliation. There is currently no pulp medicament with all the features of the ideal pulpotomy material. The present study compared the radiographic success of sodium hypochlorite with ferric sulfate (FS) when used for pulpotomy in primary molars. A retrospective analysis was performed to evaluate the success rates of primary molars pulpotomized using sodium hypochlorite or FS according to radiographic findings. Healthy 4‒10-year-old children who had pulpotomy procedures on primary molars between 2018 and 2021 at the pediatric dental clinic and had a control radiograph at least 12 months later were enrolled in the study. The chi-squared test was used to determine the differences in success between these two materials. A total of 142 teeth, including 85 (59.9%) first primary molars and 57 (40.1%) second primary molars, in 98 healthy children were evaluated. The mean follow-up period of the teeth included in the study was 585.1±249.4 days. Radiographic success rates for NaOCl and FS groups were 73.8% and 71.0%, respectively, with no statistically significant difference (P>0.05). Internal root resorption (IRR) was the most common cause of radiographic failure in both groups. Radiographic success rates of both materials were similar, and using these materials in primary molar pulpotomy procedures can be recommended in clinical practice.

Pulp tissue dissolution capacities of different irrigation agitation techniques in artificial internal resorption cavities.

The aim of this in vitro study was to compare the organic tissue dissolution capacities of 3 different irrigation agitation techniques (IATs) in artificial internal root resorption cavities (IRCs). Ninety freshly extracted maxillary human incisors were selected. After decoronation procedure, the roots were split longitudinally, and a standard IRC were prepared in the canals on each half of the roots. Then, the bovine pulp samples (~2,3 mg) were previously weighed and placed into the cavities. The root fragments were reassembled and cemented to create a circular IRC within the canal. Teeth samples were randomly divided into 6 groups (n=15); sodium chlorur (NaCl) and sonic irrigation (SI), sodium hypochlorite (NaOCl) and SI, NaCl and passive ultrasonic irrigation (PUI), NaOCl and PUI, NaCl and laser activated irrigation (LAI), NaOCl and LAI. After that, the teeth were decemented and the tissue samples inside the cavities were weighed again. The percentage of weight loss was calculated and statistically analyzed. SI has significantly more successful results than PUI and LAI in groups which the irrigant was NaCl. There was also a significant difference between LAI and PUI in groups which the irrigant was NaOCl (Group 6 ˃ Group 4, p=0.003). There was no significant difference between LAI and SI with NaOCl. Complete dissolution of bovine pulp tissue from IRCs was not achieved by any tested techniques. However, the LAI with NaOCl was more effective than other IATs. In addition, there is no significant difference between the LAI and SI with NaOCl.

Root Resorption in the Permanent Teeth. A Review

The loss of dental hard tissue as a result of odontoclastic activity is known as root resorption. It is unwanted and pathological in permanent teeth. Root resorption may happen within the root canal called internal root resorption or on the outer surface of the root called external root resorption. Regardless of where it occurs, root resorption is irreparable, can cause pain for the patient, necessitates treatment, and in some circumstances, resulting in the early loss of the affected tooth. It might be challenging to precisely diagnose and treat root resorption. There is limited information within literatures on root resorption therefore this review aims to understand the radiological and clinical characteristics of root resorption with evaluation of their effect in accurate diagnosis and management of root resorption in permanent teeth.

Evaluation of Second Canals in Mandibular Incisors using Magnification: A Cross-Sectional Study

Background: It is essential to have a thorough understanding of the typical anatomy of the root canal system, as well as the various common and uncommon anatomical variations, in order to achieve successful treatment outcomes.Objective: To determine the frequency and pattern of two canals in mandibular incisors using magnifying loupe Material and Methods: This study at Saidu College of Dentistry in Swat included 385 participants selected consecutively. Inclusion criteria were males and females aged 20-60 years with mandibular incisor-related dental conditions. Exclusion criteria were local anesthesia allergies, internal root resorption, calcified canals, and pregnancy. The number of canals was recorded radiographically using the SLOBE technique. Canals were classified using Vertucci's system. Canal frequencies were analyzed by gender and tooth types using chi-square tests (p&lt;0.05).Results: The mean age was 33.97±11.10 years. Of the participants, 215 (55.84%) were males. The highest numbers of tooth types were found among the left lateral incisors (n=148, 38.44%) and left central incisors (n=122, 31.69%). Second canal was found 139 participants (36.10%). Among these, Type I (n=84, 21.82%) was the most common two-canal pattern, followed by Type III (n=36, 9.35%). When analyzing the canal types within the single canal group, Type I was the most prevalent in both males (23.26%) and females (20.00%). The frequencies of Types II, III, and IV were similar between genders and did not exhibit significant differences (p=0.865). The distribution of canal types varied across tooth types, with Type I being the most common, but not statistically significant (p=0.652).Conclusion: The presence of a second canal in the mandibular incisors is quite common. The most common pattern of two canals, according to the Vertucci classification, was Type I, followed by Type III.Keywords: Magnification, Mandibular incisors, Second canals, Vertucci classification

Comparison of the Hall Technique and Conventional Compomer Restorations: A 60-Month Follow-up

Objective: The Hall Technique is one biological strategy for sealing carious lesions with preformed metal crowns in primary molars. This study aimed to compare the Hall Technique's survival rate with conventional compomer restorations in caries management in primary molars for 60 months.&#x0D; Methods: Children with preformed metal crowns placed with Hall Technique and conventional compomer restorations were invited to Pediatric Dentistry Clinics for a 60-month follow-up. The restorations of these children were evaluated clinically and radiographically. Dental health records of 12 and 24-month follow-up appointments were obtained from the electronic archive. The survival rate of the restorations was evaluated by Kaplan-Meier analysis and the success/failure of the restorations by the Chi-Square test. Restorations with finding such as secondary caries, pulpitis, restoration wear/fracture/loss, crown perforation, inter-radicular radiolucency, and internal root resorption were scored according to major and/or minor failure criteria, while satisfactory ones were scored as successful.&#x0D; Results: Twenty-six primary molars were included in the study. There was no significant difference in the survival rates of preformed metal crowns placed with the Hall Technique (92.3%) and conventional compomer restorations (84.6%) at 60-month follow-up (2 = 2.455, p = .48). The Hall Technique (84.6%) was found significantly more successful clinically and radiographically compared to conventional compomer restorations (23.1%) according to the success or failure criteria in 60-month follow-up (p &lt; .01).&#x0D; Conclusion: The Hall Technique was clinically and radiographically more successful than conventional compomer restorations according to the success or failure criteria at 60-month follow-up. The Hall Technique had a similar survival rate to the conventional compomer restorations as well as low failure findings in caries management in primary molars.