Teeth resorption

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External tooth root resorption
  • A pathological process in which the roots of permanent teeth are resorbed.
  • We distinguish:
  1. Internal resorption (starts inside the tooth from the pulp side);
    • causes: pulpitis chronica clausa, does not cause problems.
  2. 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

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References[edit | edit source]

  • LIŠKA, Karel. Orofacial Pathology. 1. edition. publisher, 1983. 159 pp. ISBN 3180840161.
  • WEBER, Thomas. Memorix of Dentistry :  translation 2nd edition, 279 illustrations. 1. edition. Grada, 2006. 430 pp. ISBN 80-247-1017-X.