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. 2013 Jan;16(1):4-8.
doi: 10.4103/0972-0707.105290.

Tooth resorption part I - pathogenesis and case series of internal resorption

Marina Fernandes  1 , Ida de Ataide, Rahul Wagle
Affiliations

Tooth resorption part I - pathogenesis and case series of internal resorption

Marina Fernandes et al. J Conserv Dent. 2013 Jan.

Abstract

Resorption is a pathologic process that often eludes the clinician with its varied etiologic factors and diverse clinical presentations. The key cells involved in tooth resorption are odontoclasts which are multinucleated cells that produce resorption lacunae. Resorption can be classified as internal and external resorption. Internal resorption has been described as a rare occurrence as compared to external resorption. This article describes the pathogenesis of tooth resorption and various forms of internal resorption along with some clinical cases. Early diagnosis is the key factor in the successful management of resorptive lesions.

Keywords: Calcium hydroxide; internal root resorption; mineral trioxide aggregate; osteoclast; resorption.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Diagram showing the formation of osteoclasts by fusion of mononuclear precursor cells, (b) Diagram depicting the role of RANK (receptor activator of nuclear factor kappa B), RANK ligand and osteoprotegerin in osteoclastogenesis, (c) Diagram showing structure of an osteoclast and the creation of an acidic micro environment, (d) Diagram showing the degradation of the inorganic matrix via the carbonic anhydrase II enzyme (CA II), disintegration of the organic matrix via cysteine proteinase (CP), collagenase (CL) and matrix metalloproteinase (MMP) enzymes and the transcytosis of the degraded products
Figure 2
Figure 2
(a) Preoperative radiograph showing internal resorption in tooth #8 of a 49-year-old female patient, (b) Obturation of the canal and resorptive defect using the warm vertical compaction technique
Figure 3
Figure 3
(a) Perforating internal resorptive defect in tooth #10 of a 31-year-old male patient, (b) Sectional cone gutta-perchaobturationin the apical third of canal, (c) Repair of resorptive defect with MTA
Figure 4
Figure 4
(a) Tooth #9 showing internal replacement resorption and external root resorption in a 27-year-old male patient. Radio opaque metaplastic tissue seen in the canal space, (b) Deviation of the negotiating file towards the mesial aspect, (c) Uneven flow of calcium hydroxide paste due to the presence of metaplastic tissue, (d) Scrapping off the metaplastic tissue using an H-file, (e) Even flow of the medicament, (f) Obturation of teeth # 9 and 10 using gutta-percha
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