Teeth resorption

External tooth root resorption

A pathological process in which the roots of permanent teeth are resorbed.
We distinguish:

Internal resorption (starts inside the tooth from the pulp side);
- causes: pulpitis chronica clausa, does not cause problems.
External resorption (begins on the outer surface of the root from the periodontium);
- causes: periapical inflammations, tumors, cysts, retained teeth, replanted teeth

Internal resorption

is caused by a chronic inflammatory process (pulpitis chronica granulomatosis interna)
- the resulting granulation tissue resorbs the surrounding dentin and cementum
if it is in the neck --> typical sign - 'pink spot
Therapy:
- endodontic treatment
- temporary filling made of Ca(OH)₂ or other bioactive materials (MTA, Biodentine,...)

External resorption

external resorption generally occurs as a result of damage to the periodontal ligaments (whether mechanical, chemical or biological)
the surrounding tissue reacts to this stimulus, it tries to break down the damaged tissue
as part of this, TZT will also be resorbed
subclassification:
- replacement resorption
  - resorbed TZT are replaced by bone that grows into them
  - a solid dentin-bone connection is formed = ankylosis
- inflammatory resorption
  - cause - from dentin (necrosis, infection)
    - toxins reach the periodontium through the dentinal tubules
    - granulation tissue is formed
    - followed by resorption
- invasive cervical resorption
  - starts from cells below the epithelial attachment
  - cells resorb the cervical region of the tooth
  - we distinguish 4 types according to severity
- surface resorption
  - e.g. as a result of orthodontic treatment
    - in the area of the pressure zone, hyaline necrosis of periodontal vessels will occur as a result of excessive pressure
    - surrounding tissue reacts to necrosis
    - the result is minor resorption visible on the root of the tooth
- pressure resorption
  - due to excessive occlusal forces
- idiopathic resorption
  - for an unknown reason
Therapy
- depends on the extent of the defect and location
  - if it is a small defect in the neck area
    1. extirpation of granulation tissue
    2. Ca(OH)₂ or other bioactive material
    3. Emdogain
  - in the apex area
    - tip resection possible
  - otherwise we can try endodontic treatment and hope