Causes of Tooth Resorption
- Resorption of bone is a normal physiological response to stimuli throughout the body
- Root resorption in permanent dentition and sometimes in the primary dentition is pathological
- Chronic stimuli damage the protective layers of the root, exposing dentin to osteoclasts
- Common causes of root resorption include inflammation from pulp necrosis, trauma, periodontal treatment, orthodontic tooth movement, and tooth whitening
- Less common causes include pressure from malpositioned ectopic teeth, cysts, and tumors
- Dental trauma
- Orthodontic treatment
- Endodontic treatment
- Periodontal disease
- Genetic factors
Pathophysiological Mechanisms of Tooth Resorption
- Osteoclasts are responsible for the resorption of the root surface
- Receptive activator of nuclear factor kappa-B ligand (RANKL) is a regulator of osteoclast function
- Osteoprotegerin (OPG) inhibits RANKL and osteoclast activity
- Bacterial presence leads to pulpal or peri-periapical inflammation, causing leukocyte chemotaxis
- Damage to the periodontal ligament can lead to RANKL release activating osteoclasts
- Activation of osteoclasts
- Release of cytokines and prostaglandins
- Interaction between RANKL and RANK
- Disruption of the balance between resorption and formation
- Inflammatory response in the periodontal ligament
Classification of Tooth Resorption
- Resorptive lesions are categorized as internal or external
- Internal root resorption involves the loss of intraradicular dentin from within the root canal
- External root resorption is the loss of tooth structure from the external surface of the tooth
- External inflammatory root resorption is caused by trauma or pressure on the root surface
- External cervical root resorption affects the cervical area of the tooth, below the epithelial attachment
- External root resorption
- Internal root resorption
- Inflammatory root resorption
- Replacement root resorption
- Surface resorption
Diagnosis of Tooth Resorption
- Clinical examination
- Radiographic imaging (e.g., periapical, panoramic, cone beam computed tomography)
- Transillumination
- Vitality tests
- Histopathological examination (in severe cases)
Treatment of Tooth Resorption
- Monitoring and observation (for mild cases)
- Endodontic therapy
- Orthodontic treatment modification
- Surgical intervention (e.g., root resection, hemisection)
- Restorative procedures (e.g., crown, bridge, implant)
Resorption of the root of the tooth, or root resorption, is the progressive loss of dentin and cementum by the action of odontoclasts. Root resorption is a normal physiological process that occurs in the exfoliation of the primary dentition. However, pathological root resorption occurs in the permanent or secondary dentition and sometimes in the primary dentition.
Root resorption | |
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Post traumatic External tooth resorption 9 | |
Specialty | Dentistry |
Symptoms | Dark tooth discoloration, swollen gums, chip tooth |
Complications | Tooth loss, infection |
Types | External (most common), internal |
Causes | Trauma, idiopathic |
Risk factors | Trauma, orthodontics |
Diagnostic method | Dental examination, X-rays |
Treatment | Dental crowns, tooth extraction, gum surgery |