Family Friendly & Specialty Dentists in London, UK
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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 categorised 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)
