Inflammatory sternal root resorption.
Patient referred to the clinic complaining of facial pain in the lower left region when warm. Diffuse pain of slow decline. On clinical examination, exacerbated pain on cold on tooth 36, therefore, pulpal diagnosis of symptomatic irreversible pulpal inflammation. Radiographic examination revealed image compatible with external root resorption in the distal root. The tooth was accessed
CT scan revealed that the resorption had communication with the root canal.
The flap was folded in an envelope to close the resorption gap with MTA, and later, in the same session, the endodontic treatment was performed.
The patient was then referred to a periodontist for restoration of the exposed region with resin and other periodontal care.
External root resorption
In: Endo et al. MUDI Archives, v19, n2-3, p. 43-52.
INTRODUCTION: According to the glossary of the American Association of Endodontics, root resorption is defined as a condition associated with a physiological or pathological process that results in the loss of dentin, cementum or bone (NE; WITHERSPOON; GUTMANN, 1999). Physiological resorption occurs in the deciduous dentition during exfoliation and allows the eruption of its successor permanent tooth (HAROKOKOPAKIS-HAJISHENGALLIS, 2007; PATEL; KANAGASINGAM; PITT FORD, 2009). On the other hand, pathological resorption can occur after traumatic injuries, orthodontic movement, chronic inflammation of infectious origin of the pulp or periodontal tissues, surgical procedures, and excessive pressure from an impacted tooth or a tumor (FUSS; TSESIS; LIN, 2003).
Resorptions can be classified as internal or external resorption. Internal root resorption is an inflammatory process that begins on the inner surface of the pulp cavity with the loss of dentin, and may reach the cementum (FUSS; TSESIS; LIN, 2003). Its etiology is not fully established, and trauma is the main etiological agent (CALISKAN; TURKUN, 1997).
While external root resorption is a loss of tooth structure, initiated by a mineralized or bare area of the root surface. Both resorptions depending on their progression can cause irreversible damage to the tooth structure, requiring appropriate treatment and monitoring. Because inflammatory root resorption is usually of infectious origin, antimicrobial strategies should be applied to improve prognosis (CVEK, 1973; SJOGREN et al., 1997).
In many clinical situations, periapical radiographs do not allow a safe and accurate diagnosis of tooth resorption, however, there are cases where the identification of the type of resorption, its degree of evolution, its limits and its cause is not definitely possible to be determined.Thus, cone beam computed tomography is shown as an additional resource in the detection of root resorption (COHENCA et al., This technology offers an image in three dimensions, eliminating the overlapping of images as observed in periapical radiographs.
