Case report: an extreme case of root resorption.
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Root Resorption↗
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Light and SEM observation of internal root resorption of a traumatized permanent central incisor.
A clinical case report is presented which illustrates internal root resorption of a traumatized tooth. Light and scanning electron microscope were used to further examine the defect. An explanation of the morphological structure of the resorption is discussed.
Adolescent↗
Effect of tetracycline and SnF2 on root resorption in replanted incisors in dogs.
The present study was made to assess the effect of applying SnF2, tetracycline, or both, to root surfaces of extracted teeth prior to replantation. In five young adult beagles, a total of 18 mandibular incisors were extracted, bench dried for 45 min, and reimplanted in their respective sockets either after no further treatment or following treatment with 1% doxycycline HCl for 5 min, 1% SnF2 for 5 min, or 1% SnF2 followed by 1% doxycycline HCl. After 4 wk of healing, the relative frequency of root resorption (surface resorption, inflammatory resorption and replacement resorption) was approximately 27% of the root surface in bench-dried as well as in doxycycline-treated specimens. By contrast, SnF2-treated and SnF2 + doxycycline-treated teeth showed less than 1% resorption. In the latter two specimen groups an inflammatory reaction in the periodontal ligament without resorption occurred with a frequency of 38.3% and 11.1%, respectively. The results indicate that application of SnF2 to the root surface prior to replantation effectively reduces resorptive processes during the first postoperative weeks. By subsequently treating the root surface with tetracycline, the adverse effect of SnF2 on periodontal connective tissue repair may be reduced.
Animals↗
[The causes of and repair procedures in external root resorption following palatal suture expansion with magnetic and conventional dilators. Experimental animal research on Macaca fascicularis monkeys].
Eight Macaca fascicularis monkeys received rapid maxillary expansion with conventional and magnetic appliances. The histomorphometric analysis (SEM) showed increased external root resorption (ERR) in: multirooted teeth, buccal root surfaces, mesiobuccal roots and apical zones. ERR is determined by the impulse, the decrease in the periodontal width and the extent of mineralization of adjacent hard tissues. The microscopic examinations of light, UV and SEM defined two types of cellular cement in ERR areas: a) unfunctional repair cement (slow type), b) functional repair cement (rapid type). The first was characterized by the absence of Sharpey's fibers and by overlapped incremental lines, the second by the formation of new Sharpey's fibers and discriminated incremental lines. These incremental lines indicate five sequential phases with diverse rates of cement apposition, i.e. lag-, incipient-, peak-, steady-, and retreating phase. Therefore, the study recommends the application of a fixed retainer immediately subsequent to rapid maxillary expansion which is followed by an intermittent retention appliance.
Animals↗
A clinical evaluation of root resorption by formocresol treatment in 120 cases of pulpotomy in permanent molars.
The effect of a formocresol pulpotomy of a 120 permanent molar showed external and internal resorption on distal root in lower molar, and palatal root in the upper molar. In this study 33.3% were male and 66.7% were female. The age distribution of patients was 16 to 20 years of age and 21 to 25 years of age. The rate of resorption for chronic pulpitis was more than acute pulpitis. The success of formocresol pulpotomy treatment at the end of the 10th year for acute pulpitis was 92.26% in contrast to 84% for chronic pulpitis.
Acute Disease↗
Determinants controlling iatrogenic external root resorption and repair during and after palatal expansion.
The mechanisms controlling iatrogenic external root resorption (ERR) and repair were studied on 8 Macaca fascicularis monkeys. The animals were divided into short-term and long-term groups, and were treated with jackscrew, magnetic and sham palatal expansion appliances. Scanning electron microscopy morphometric analysis found major evidence of ERR in the tooth-borne jackscrew appliance, in the long-term group, in the maxillary premolars, on the buccal and furcation root surfaces, on the mesiobuccal root, and in the apical zone. Correspondingly, the ERR mechanism is controlled by the impulse (F. delta t) and the critical barrier of the periodontal ligament as primary determinants and by the environmental density as a secondary determinant. ERR is initially regulated by the force component of the impulse and, with increased duration, by the time component of the impulse. The impairment/repair dynamics were found to be regulated by three principles: ERR level of irreversibility, delayed resorption response and jiggling.
Animals↗
Calcium hydroxide in the treatment of external root resorption.
A case is presented in which calcium hydroxide was used in endodontic treatment of external root resorption in a tooth with a necrotic pulp, during active orthodontic movement. A calcified deposit formed, filling a defect, and the tooth was subsequently obturated with gutta-percha. Thus, both types of therapy--endodontic and orthodontic--were performed simultaneously.
Adolescent↗
Healing of root resorption: a case report.
External resorption is sequelae of necrotic periodontal membrane over a large area of root following an injury to the tooth. This usually occurs after severe dental injuries such as intrusion, severe luxations or exarticulation injuries complicated by a prolonged extra oral period. This case report presents a clinical and radiographic follow up (13 months) of treatment of inflammatory external root resorption on maxillary central incisor using Vitapex. Gradual healing of resorption was observed radiographically with no tenderness or pathological mobility.
Adolescent↗
The relationship between apical root resorption and orthodontic tooth movement in growing subjects.
OBJECTIVE: To investigate the relationship between apical root resorption and orthodontic tooth movement in growing subjects. METHODS: 58 growing subjects were collected randomly into the study sample and another 40 non-treated cases were used as control. The apical resoption of the upper central incisors was measured on periapical film and the incisor displacement was measured on lateral cephalogram. Using multiple linear regression analysis to examine the relationship between root resoption and the displacement of the upper incisor apex in each of four direction (retraction, advancement, intrusion and extrusion). RESULTS: The statistically significant negative association were found between resorption and both intrusion (P < 0.001) and extrusion (P < 0.05), but no significant association was found between resorption and both retraction and advancement. The regression analysis implied an average of 2.29 mm resorption in the absence of apical displacement. CONCLUSIONS: The likelihood that the magnitude of displacement of the incisor root is positively associated with root resoption in the population of treated growing subjects is very small.
Humans↗
Apical root resorption in orthodontically treated adults.
This study analyzed the relationship in orthodontically treated adults between upper central incisor displacement measured on lateral cephalograms and apical root resorption measured on anterior periapical x-ray films. A multiple linear regression examined incisor displacements in four directions (retraction, advancement, intrusion, and extrusion) as independent variables, attempting to account for observed differences in the dependent variable, resorption. Mean apical resorption was 1.36 mm (sd +/- 1.46, n = 73). Mean horizontal displacement of the apex was -0.83 mm (sd +/- 1.74, n = 67); mean vertical displacement was 0.19 mm (sd +/- 1.48, n = 67). The regression coefficients for the intercept and for retraction were highly significant; those for extrusion, intrusion, and advancement were not. At the 95% confidence level, an average of 0.99 mm (se = +/- 0.34) of resorption was implied in the absence of root displacement and an average of 0.49 mm (se = +/- 0.14) of resorption was implied per millimeter of retraction. R2 for all four directional displacement variables (DDVs) taken together was only 0.20, which implied that only a relatively small portion of the observed apical resorption could be accounted for by tooth displacement alone. In a secondary set of univariate analyses, the associations between apical resorption and each of 14 additional treatment-related variables were examined. Only Gender, Elapsed Time, and Total Apical Displacement displayed statistically significant associations with apical resorption. Additional multiple regressions were then performed in which the data for each of these three statistically significant variables were considered separately, with the data for the four directional displacement variables. The addition of information on Elapsed Time or Total Apical Displacement did not explain a significant additional portion of the variability in apical resorption. On the other hand, the addition of information on Gender to the information on the four directional displacement variables yielded an R2 value of 0.35, which indicated that these variables taken together could account for approximately a third of the observed variability in apical resorption in this sample.
Adult↗
A case of progressive external root resorption.
This case report describes a radiographical, histological and histochemical study of an extracted mandibular tooth with progressive external root resorption. The cells which appeared to be responsible for the hard tissue resorption showed an intense acid phosphatase activity, similar to that of bone-resorbing cells. Some aspects on the etiology and pathogenesis of resorptive process that occurred in the present case are discussed.
Acid Phosphatase↗
Immediate esthetic treatment of an avulsed/replanted permanent incisor with extensive root resorption: a case report.
This article describes the treatment of a 10 year-old patient with complete root resorption of the maxillary permanent incisor following avulsion and replantation 4 years earlier. The remaining natural crown was used to immediately solve the esthetic problem created by its extraction. The crown was attached with an orthodontic wire and composite resin to adjacent teeth. This temporary treatment does not elicit any damage to adjacent teeth, and can be easily removed. Therefore, it does not affect any plans that might be considered in the future as the permanent treatment.
Child↗
[Root resorption. 1. Etiopathogenesis, diagnosis and clinical manifestations].
The authors, after having thoroughly reviewed the literature regarding all types of root resorption, specifically investigated those of clear endodontic pertinence, and evaluated the etiopathogenesis, the possibility of diagnosis, and the clinical incidence.
Dental Occlusion, Traumatic↗
Surgical-restorative treatment of bleaching-related external root resorption.
Three teeth in 2 patients were treated after intracoronal bleaching with 30% hydrogen peroxide had resulted in external root resorption. An attempt to treat one tooth by placing an intracoronal dressing with calcium hydroxide had failed. The resorption defects were exposed surgically by reducing and re-contouring the alveolar crest. The restorations were made during the surgical procedure, with a light-cured composite in one case and with amalgam in the other, and were of compromised quality due to the difficulty of control. One year follow-up examinations revealed periodontal complications in both cases, in the form of a further resorption of the alveolar crest and gingival edema. These sequelae suggested that the restoration of bleaching-related resorption defects should have been a secondary stage, after the surgical exposure of the defects had been completed first. For the purpose of exposing the defects, the level of the alveolar crest should be reduced enough to secure a biological width from the restorations.
Adult↗
Root resorption associated with an impacted mesiodens: a surgical and endodontic approach to treatment.
This article describes a case of root resorption of a maxillary non-vital immature incisor associated with an impacted and angulated mesiodens. The impacted tooth was surgically removed and the compromised incisor was subsequently endodontically treated. Over a period of 27 months the tooth was medicated with repeated applications of calcium hydroxide. Radiographically after 18 months, an incomplete hard tissue barrier was observed with full apical closure at the conclusion of 27 months of treatment. Once the patient was comfortable after surgical removal of the mesiodens, the tooth was asymptomatic and remained so for the duration of the treatment and after definitive restorative work had been completed.
Child↗
Maxillary incisor root resorption in relation to the ectopic canine: a review of 26 patients.
A retrospective study of 26 patients with maxillary incisor root resorption relating to the presence of an ectopic canine was undertaken from case records. The group consisted of nine male and 17 female patients with a mean age of 12.5 years. There was a total of 35 resorbed teeth, 26 lateral and nine central incisors, and these were related to 32 ectopic canines. The resorption tended to be extensive, 30 teeth had pulpal involvement. In two-thirds of cases the pattern of resorption involved both apical and middle thirds of the root. Despite the extensive nature of the involvement there were few clinical signs and symptoms reported by patients. 43.8 per cent of canines were lying palatal to the arch, 18.7 per cent were in the line of the arch and 37.5 per cent were buccal. Significantly 15.6 per cent were buccal and erupted. The path of canine eruption was mesio-horizontal in 21 cases. No relationship could be found between resorption and the retention or loss of the deciduous canine. The canine root formation was virtually complete in 31 of the involved canines. The study indicated that the problem is often diagnosed late both in relation to the patient's age and the extent of resorption present. It is suggested that the problem may be underestimated by dental practitioners.
Age Factors↗
Complete root resorption of an upper central incisor due to ectopic eruption of canine in a deaf-mute child.
Unilateral complete root resorption of the permanent central incisor was experienced in a boy with deaf and dumb. Transposition of tooth germ or abnormally directed eruption of the canine caused not only an entire root but a part of enamel resorption. The patient was diagnosed clinically and radiographically as an ectopic eruption of the right maxillary upper canine and then treatments were provided to improve esthetic and functional conditions in terms of eruption guidance. It should be emphasized that the early diagnosis and the subsequent eruption guidance is essential in the patient with these kinds of eruption disorder of the mixed dentition.
Adolescent↗
Cytodifferentiation and degeneration of odontoclasts in physiologic root resorption of kitten deciduous teeth.
To investigate the cytodifferentiation and degeneration of odontoclasts in physiologic root resorption, we studied deciduous incisors undergoing resorption in 6-month-old kittens by electron microscopy of ultrathin sections. The endogenous peroxidase activity within the cells was also examined by incubating the tissue slices in diaminobenzidine-H2O2 medium. The resorbing tissues, consisting of multinucleated giant cells, macrophages, granular leukocytes, fibroblasts and many blood vessels, were observed at the resorbing surface of the root dentine. Macrophages and granular leukocytes exhibited endogenous peroxidase activity, but mononuclear and multinucleated preodontoclasts and multinucleated odontoclasts did not. These preodontoclasts contained abundant mitochondria, a moderate amount of rough endoplasmic reticulum, stacks of Golgi membranes, lysosomes and numerous polyribosomes scattered throughout the cytoplasm. Many cellular processes extended from their cell surfaces by which the preodontoclasts appeared to fuse to one another during their multinucleation. Concomitant with the multinucleation process, the preodontoclasts developed numerous pale vacuoles throughout the cytoplasm. These vacuoles seemed to arise from some smooth endoplasmic reticula, perhaps representing Golgi-endoplasmic reticulum-lysosome, and the Golgi saccules. However, the preodontoclasts did not yet form a ruffled border and clear zones. When these preodontoclasts came into direct contact with resorbing dentine surfaces, they began to form the clear zones against dentine surfaces. Characteristically, numerous pale vacuoles were accumulated in the cytoplasm adjacent to the clear zone, then they penetrated into the cytoplasm of the clear zone, and with this, ruffles of the plasma membranes appeared. Through a further movement of more pale vacuoles towards the ruffled plasma membranes, the odontoclasts developed typical ruffled borders against the resorbing dentine surfaces. At this differential phase, little pale vacuoles appeared in the Golgi area, but the cisterns of the Golgi apparatus themselves reached their greatest extent during cellular differentiation. Fully differentiated odontoclasts frequently extended long broad cellular processes into the dentinal tubules exposed to the resorption lacunae. Although some odontoclastic processes penetrating the dentinal tubules contained vacuoles and lysosomal structures, most processes lacked any cytoplasmic organelles, and their cytoplasm resembled that of the clear zone. But these processes never exhibited ruffled-border-like structures.(ABSTRACT TRUNCATED AT 400 WORDS)
Animals↗