External Inflammatory Root Resorption: Management of a Tooth with hopeless Prognosis

ABSTRACT The treatment of external root resorption and associated periodontal defect can be challenging to the most ingenious clinician. A correct diagnosis and an understanding of the etiology and dynamics of root resorption, which is the progressive loss of dentin and cementum through action of osteoclastic cells, are critical for effective management. The article describes the management of an external root resorption in maxillary central incisor where a combined endo-perio management strategy was implemented. Cone beam computed tomography was used as an adjunctive diagnostic aid. A combined approach using biodentine for root surface repair, bone graft, collagen membrane, and platelet-rich fibrin to address the associated osseous lesion appears to be viable modality in treatment of the same. After a follow-up period of 12 months, the patient was found to be asymptomatic. Postoperative radiographs also demonstrated satisfactory bone fill and arrest of the resorptive lesion. How to cite this article Abhilash R, Balan J, Shoba K, Sreelakshmi MR. External Inflammatory Root Resorption: Management of a Tooth with hopeless Prognosis. Cons Dent Endod J 2017;2(1):24-27.

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Healing of root resorption: a case report

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.27.3.5n213546817741x7 ◽

2003 ◽

Vol 27 (3) ◽

pp. 235-238 ◽

Cited By ~ 1

Author(s):

Sham Bhat ◽

S. Sharan ◽

Imneet Madan

Keyword(s):

Case Report ◽

Root Resorption ◽

Central Incisor ◽

Large Area ◽

Maxillary Central Incisor ◽

External Root Resorption ◽

Periodontal Membrane ◽

Dental Injuries

External resorption is sequelae of necrotic periodontal membrane over a large area of root following an injury to the tooth. This usually occurs after severe dental injuries such as intrusion, severe luxations or exarticulation injuries complicated by a prolonged extra oral period. This case report presents a clinical and radiographic follow up (13 months) of treatment of inflammatory external root resorption on maxillary central incisor using Vitapex®. Gradual healing of resorption was observed radiographically with no tenderness or pathological mobility.

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Application of High-Frequency Conduction for Persistent Apical Periodontitis: A Case Report

Journal of Dentistry & Oral Disorders ◽

10.26420/jdentoraldisord.2021.1168 ◽

2021 ◽

Vol 7 (4) ◽

Author(s):

Toshihiko Tominaga ◽

◽

Eiichiro Tada ◽

Kazuki Takahira ◽

Tsutomu Sugaya ◽

...

Keyword(s):

Root Canal ◽

High Frequency ◽

Root Resorption ◽

Root Surface ◽

Apical Periodontitis ◽

Root Canal Filling ◽

Tissue Inflammation ◽

External Root Resorption ◽

Ultrasonic Irrigation

We report the case of a 39-year-old male with Persistent Apical Periodontitis (PAP) caused by infection in an uninstrumented area, wherein conventional chemical root canal treatment is not possible, which was sterilized via highfrequency conduction. He underwent root canal filling after multiple endodontic treatments for tooth #4. As symptoms recurred, he was referred to our department with the chief complaint of dull pain during mastication. Present symptoms were percussion pain of the tooth, buccal mucosa swelling at the apical portion, and grade 1 mobility. Radiography revealed inadequate root canal filling. A radiolucent image 5×6 mm in diameter and with an unclear boundary was observed around the apex. External root resorption was mainly observed in the apical foramen, with a crown root ratio of approximately 1:1. Using 6% sodium hypochlorite under dental microscopy, chemomechanical root canal preparation was performed. Passive ultrasonic irrigation and calcium hydroxide application were conducted three times; however, periapical tissue inflammation did not subside. Therefore, the patient was diagnosed with PAP, and the uninstrumented area was sterilized via high-frequency conduction. High-frequency currents were applied to the apex, root surface, and periapical lesion at 500 kHz and 90 V; periapical tissue inflammation resolved after 2 weeks. Subsequently, the root canal was filled. Follow-up radiography revealed a bone regeneration-like image at 2 months. Bone defects healed at 11 months. Although surgical endodontic therapy is conventionally performed in PAP patients, high-frequency conduction could be a minimally invasive nonsurgical endodontic treatment option for uninstrumented areas in PAP patients.

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External Root Resorption Management of an Avulsed and Reimplanted Central Incisor: A Case Report

Dentistry Journal ◽

10.3390/dj9060072 ◽

2021 ◽

Vol 9 (6) ◽

pp. 72

Author(s):

Gianni Di Giorgio ◽

Alessandro Salucci ◽

Gian Luca Sfasciotti ◽

Flavia Iaculli ◽

Maurizio Bossù

Keyword(s):

Case Report ◽

Calcium Silicate ◽

Root Resorption ◽

Signs And Symptoms ◽

Clinical Results ◽

Permanent Teeth ◽

Central Incisor ◽

Maxillary Central Incisor ◽

External Root Resorption

Background: Avulsion and reimplantation of permanent teeth represent a major challenge in terms of treatment and long-term prognosis. The present study reported clinical management of external root resorption of an avulsed and reimplanted maxillary central incisor. Case report: A 9-year-old boy reported an uncomplicated crown fracture and avulsion of tooth 11 and complicated crown fracture of tooth 21 due to trauma. Reimplantation of element 11 was obtained within 30 min post-trauma and 3 days after both elements were diagnosed with necrotic pulp. In addition, tooth 11 showed early external root resorption. Both elements underwent endodontic treatment and root closure with apical plug using calcium-silicate-based cement. At 6-month follow-up root resorption appeared to be arrested. Twenty-four months after trauma the clinical results were stable, although signs and symptoms of ankylosis were observed. Conclusions: An immediate endodontic approach and use of calcium-silicate-based cement seemed to contrast the progression of root resorption of an avulsed and reimplanted central incisor after 24 months of follow-up.

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Application of cone-beam computed tomography in the management of dilacerated maxillary central incisor associated with radicular cyst and external root resorption - A case report

Journal of Conservative Dentistry ◽

10.4103/jcd.jcd_57_21 ◽

2021 ◽

Vol 24 (4) ◽

pp. 399

Author(s):

R Manjushree ◽

Keerthi Prasad

Keyword(s):

Computed Tomography ◽

Case Report ◽

Cone Beam Computed Tomography ◽

Root Resorption ◽

Cone Beam ◽

Radicular Cyst ◽

Central Incisor ◽

Maxillary Central Incisor ◽

External Root Resorption

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Treatment of maxillary central incisor with external root resorption using mineral trioxide aggregate: 18 months follow-up

BMJ Case Reports ◽

10.1136/bcr-2013-200241 ◽

2013 ◽

Vol 2013 (jul08 2) ◽

pp. bcr2013200241-bcr2013200241 ◽

Cited By ~ 1

Author(s):

P. Gandi ◽

S. Disha

Keyword(s):

Root Resorption ◽

Mineral Trioxide Aggregate ◽

Central Incisor ◽

Maxillary Central Incisor ◽

External Root Resorption

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Respuesta del ligamento periodontal a la avulsión dental. Reporte de caso / Periodontal Ligament Response to Dental Avulsion. Case Report

Universitas Odontologica ◽

10.11144/javeriana.uo35-75.rlpa ◽

2017 ◽

Vol 35 (75) ◽

Author(s):

Raúl Solórzano Santos ◽

Antonio José Díaz-Caballero ◽

Eduardo Covo Morales

Keyword(s):

Case Report ◽

Periodontal Ligament ◽

Root Resorption ◽

Root Surface ◽

Permanent Teeth ◽

Traumatic Lesion ◽

External Root Resorption ◽

Type K ◽

Dental Avulsion

RESUMEN. Antecedentes: La avulsión es un tipo de lesión traumática poco frecuente en la dentición permanente. La reabsorción radicular externa es un evento común posterior al reimplante de un diente avulsionado. Objetivo: Reportar un caso de trauma de dos dientes reimplantados, en el que se obtuvieron resultados satisfactorios con 26 semanas de seguimiento. Reporte del caso: Manejo clínico de paciente de sexo masculino de 8 años de edad que se presenta a la clínica del Postgrado de Endodoncia de la Universidad de Cartagena, Colombia, con antecedente de avulsión y posterior reimplante con ferulización de los dos incisivos centrales superiores. Los dientes fueron preparados hasta lima 50 tipo K, medicados con hidróxido de calcio y obturados con MTA. Resultados: Se observó cicatrización de la superficie radicular con disminución de las zonas de reabsorción externa radicular después de 26 semanas de seguimiento. Conclusión: La reabsorción radicular externa en dientes avulsionados reimplantados puede contrarrestarse en la medida que hayan sido manejados con conocimiento profesional, dentro de un marco de tiempo y condiciones biológicas. ABSTRACT. Background: Dental avulsion is a rare traumatic lesion in permanent teeth. External root resorption is a common event after reimplantation of an avulsed tooth. Purpose: To report a case of two reimplanted teeth with satisfactory results after controls during 26 weeks. Case report: Clinical management of an 8-year-old boy that seeks attention in the clinic of the Postdoctoral Program in Endodontics of University of Cartagena with background of avulsion of both central upper incisors. The teeth were prepared up to a type K # 50 file, medicated with calcium hydroxide and later filled with MTA. Results: Healing was observed on the root surface with reduction of the external radicular resorption after a 26-week follow-up. Conclusion: External radicular resorption can be counteracted as long as its handling was performed professionally within parameters of time and biological conditions.

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Cone beam computed tomography for the diagnosis of external root resorption associated with orthodontic treatment: A review.

Revista Científica Odontológica ◽

10.21142/2523-2754-0803-2020-037 ◽

2020 ◽

Vol 8 (3) ◽

pp. e037

Author(s):

Mariela Burgos-Urey ◽

Jhoana Mercedes Llaguno-Rubio

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Orthodontic Treatment ◽

Root Resorption ◽

Imaging Techniques ◽

Cone Beam ◽

Advantages And Disadvantages ◽

External Root Resorption ◽

Management Protocol

External root resorption (ERR) is a highly prevalent, multifactorial problem frequently associated with orthodontic treatment. Treatment is complex due to the lack of solid knowledge regarding predisposing factors, systematic management for diagnosis and follow-up protocols or thefundamental theoretical bases of adequate imaging tools for each situation. This review describes the indications of the use of cone beam computed tomography (CBCT) and the factors related to its development and the characteristics of the techniques used in the diagnosisand monitoring of ERR in orthodontics. We compared the advantages and disadvantages of CBCT based on the risk/benefits. Methods: We have reviewed and summarized the information and the risk factors available on ERR in orthodontics and the use of CBCT in the diagnosis and follow-up of ERR with the aim of developing a management protocol. Likewise, CBCT is compared with other imaging techniques frequently used in ERR. The articles reviewed in this study coincide in terms of the advantages of precision of CBCT in the detection and linear and volumetric measurement of ERR associated with orthodontics over two-dimensional techniques. However, CBCT cannot completely replace other imaging techniques since its effectiveness is not significantly greater in cases with moderate ERR compromise. The use of CBCT should be optimized following specific criteria for its application.

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Lateral Luxation of Incisor - A Case Report of Using a New Cone-Beam Computed Tomography Software and Reposition Guideline

Brazilian Dental Journal ◽

10.1590/0103-6440202003069 ◽

2020 ◽

Vol 31 (3) ◽

pp. 337-343

Author(s):

Priscilla Barbosa Ferreira Soares ◽

Andomar Bruno Fernandes Vilela ◽

Camilla Christian Gomes Moura ◽

Carlos Estrela ◽

Mike R Bueno ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Root Resorption ◽

Correct Diagnosis ◽

Dental Trauma ◽

Cone Beam ◽

Maxillary Central Incisor ◽

Digital Reconstruction ◽

Trauma Injury ◽

The Right

Abstract Lateral luxation injuries are one of the most severe periodontal injuries in dental trauma. The correct diagnosis followed by repositioning of the tooth on the right position is fundamental for the periodontal ligament healing. This study reported a clinical case of lateral luxation of maxillary central incisor involving a new cone beam computed tomography (CBCT) software for reconstruction (e-Vol DX) to confirm the lateral luxation after no conclusive dental trauma injury definition by using conventional exam. The lateral luxation injury was digitally reduced by insertion of tooth back to its alveolus, and at the same session, the tooth was stabilized with a rigid splint and further changed to a semi-rigid nylon splint. During the pulpal status monitoring, the pulp was diagnosed necrotic, then the root canal was treated to prevent root resorption. External office-bleaching and restorative procedure was performed. The 4-years follow up and new imaging exam and digital reconstruction confirmed bone healing and no complication. CBCT images analyzed by eVol DX can be used to determine and to guide lateral luxation treatment.

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Fifteen-year Clinical Follow-up of Restoration of Extensive Cervical Resorption in a Maxillary Central Incisor

Operative Dentistry ◽

10.2341/15-131-s ◽

2017 ◽

Vol 42 (2) ◽

pp. E55-E58 ◽

Cited By ~ 1

Author(s):

EG Reston ◽

RPR Bueno ◽

LQ Closs ◽

J Zettermann

Keyword(s):

Root Resorption ◽

Treatment Options ◽

Glass Ionomer Cement ◽

Central Incisor ◽

Endodontically Treated Teeth ◽

Maxillary Central Incisor ◽

External Root Resorption ◽

Fixed Prosthodontics ◽

Single Structure ◽

The One

SUMMARY Internal bleaching in endodontically treated teeth requires care and protection to prevent harm to the periodontal ligament due to peroxide and may result in external root resorption. There is a myriad of treatment options when this occurs, such as monitoring, extraction, and subsequent rehabilitation with implants or fixed prosthodontics. In some cases, such as the one described here, a conservative attempt to maintain the tooth as a single structure can be made by sealing the resorptive defect. In the present case, we show a multidisciplinary approach where orthodontics, periodontics, and restorative dentistry were involved in treating the maxillary right central incisor (#8) of a 65-year-old patient with extensive cervical resorption, whose chief complaint was esthetics. The proposed treatment was extrusion of the tooth followed by curettage and restoration of the defect with glass ionomer cement. The patient has been followed for 15 years with no signs of recurrence, maintenance of periodontal health, and patient satisfaction with the esthetic outcome.

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