Root perforating internal replacement resorption: a case report clinical with 10-year follow-up

This study aims to report a root perforating internal replacement resorption treated and followed up for ten years. A 19-years female showed in periapical tomography enlargement of the entire length of the root canal of tooth 11. The cone-beam computed tomography (CBCT) showed a hypodense area with jagged edges involving the pulp cavity space and communication with the periodontium. After being accessed and prepared, the canal and its resorption defect were obturated with mineral trioxide aggregate. The cervical third was sealed with glass ionomer, and the tooth was restored with composite resin. Ten years later, the tomography showed intact root canal filling and periapical and periodontal injury absence. The use of repair cement for root canal obturation with perforating internal replacement resorption is an alternative for these cases, being fundamental to have a clinical, radiographic and tomographic follow-up to evaluate the treatment success.

Estudio tridimensional de reabsorciones internas obturadas con gutapercha inyectable o cono único de gutapercha más sellador biocerámico / Three-dimensional study of internal resorptions obturated with injected gutta-percha or single guttapercha cone and bioceramic sealer

Objetivo: Evaluar ex vivo, mediante reconstrucción tridimensional con tomografía computarizada de haz cónico, la presencia de vacíos, el volumen y la adaptación de la obturación a las paredes de conductos con reabsorciones dentinarias internas simuladas empleando gutapercha inyectable o cono único de gutapercha más sellador biocerámico. Materiales y métodos: Se utilizaron 10 incisivos centrales superiores humanos extraídos, en cada uno de los cuales se talló una reabsorción artificial para su obturación. La muestra fue sometida, de manera sucesiva, a dos condiciones experimentales diferentes: grupo 1, gutapercha inyectable con sistema EQ-V Master; grupo 2, cono de gutapercha más sellador biocerámico BioRoot RCS. Luego, se realizaron tomografías computarizadas de haz cónico y se hizo el estudio tridimensional. A continuación, se utilizó un programa para identificar los vacíos en la obturación y analizar cuantitativamente el volumen y la superficie cubierta por la obturación en los tercios coronario, medio (ampolla) y apical. Los datos fueron evaluados con la prueba de Wilcoxon (P<0,05). Resultados: El volumen de obturación y la superficie dentinaria en contacto con la obturación fueron similares para las dos técnicas empleadas. Las diferencias entre ambos grupos no fueron estadísticamente significativas (P>0,05). Conclusión: Aunque se observaron vacíos con ambas técnicas (en contacto con la superficie dentinaria cuando se empleó gutapercha inyectable, y en el interior de la obturación cuando se usó cono único de gutapercha más sellador BioRoot RCS), las dos rellenaron adecuadamente las reabsorciones simuladas (AU)

Aim: Ex vivo, tridimensional evaluation with cone beam computed tomography (CBCT), of the presence of voids, the obturation volume and adaption to the root canal walls with simulated internal root resorption, using injected gutta-percha or bioceramic sealer with single gutta-percha cone. Materials and methods: Ten maxillary extracted central human incisors were used and artificial internal root resorption was created in each one. For the root canal obturation, each tooth was subjected to two different experimental conditions successively, conforming two matched groups: Group I: EQ-V Master injected thermo plasticized gutta-percha system. Group II: gutta- percha point plus BioRoot RCS bioceramic sealer. First, the root canals were filled with injected gutta-percha and then, with the bioceramic sealer. Then the teeth were scanned with CBCT and subsequently a digital three-dimensional reconstruction was performed. The presence of voids, obturation volumne and the dentin wall surface covered by the filling material was quantitative analyzed through a software; at the coronal, middle (blister) and apical thirds. The data was analyzed by using Wilcoxon test (P<0.05). Results: The filling material volume and the dentin wall surface covered by it, was similar in both root canal obturation techniques. There was no significant difference between both groups (P>0.05). Conclusion: Although voids were observed in both groups (when the injected thermo plasticized gutta-percha system was used the voids were at the external surface and when BioRoot RCS + gutta-percha cone was used the voids were into the filling material), the obturation of simulated root canal resorption cavities was similar with both obturation techniques (AU)

Láser de baja potencia como coadyuvante en tratamiento endodóntico de pieza con reabsorción interna y lesión apical: reporte de un caso / Use of low level laser as an adjunct in endodontic treatment of teeth with internal resorption and apical lesión

La reabsorción radicular interna es infrecuente en dentición permanente, la mayoría de los casos se observan en dientes anteriores, su etiología no está del todo clara, es por esto que el tratamiento para este tipo de lesiones es la endodoncia. Se presenta el caso de una paciente sexo femenino, 38 años de edad, sin antecedes médicos relevantes, derivada para evaluación de diente 2.2 con mal pronóstico. El diagnóstico es de absceso apical agudo, pieza con reabsorción interna y lesión apical. Se realiza endodoncia con cementos biocerámicos y aplicación de láser terapéutico de 808 nm de longitud de onda, con parámetros específicos para acelerar la reparación del tejido óseo. La terapia de fotobiomodulación con láser de baja potencia parece ser útil como coadyuvante en el proceso de reparación ósea en piezas con lesión apical y reabsorción interna tratadas endodónticamente.

Internal root resorption is infrequent in permanent dentition, most cases are observed in anterior teeth, its etiology is not entirely clear, which is why the treatment for this type of lesion is endodontics.We present the case of a 38-year-old female patient, without relevant medical history, referred for evaluation of tooth 2.2 with a poor prognosis. Diagnosis Acute apical abscess, tooth with internal resorption and apical lesion. Endodontics are performed with bioceramic cements and the application of a 808 nm wavelength therapeutic laser, with specific parameters to accelerate bone tissue repair.Low-level laser photobiomodulation therapy appears to be useful as an adjunct in the bone repair process in endodontically treated teeth with apical lesion and internal resorption.

The four mechanisms of dental resorption initiation

The aim of this study is to present a classification with a clinical application for root resorption, so that diagnosis will be more objective and immediately linked to the source of the problem, leading the clinician to automatically develop the likely treatment plan with a precise prognosis. With this purpose, we suggest putting together all diagnosed dental resorptions into one of these four criteria: 1) Root resorption caused by cementoblast cell death, with preservation of the Malassez epithelial rests. 2) Root resorption by cementoblasts and Malassez epithelial rests death. 3) Dental resorption by odontoblasts cell death with preservation of pulp vitality. 4) Dental resorption by direct exposure of dentin to gingival connective tissue at the cementoenamel junction gaps.

O presente trabalho propõe-se a apresentar uma classificação, com aplicação clínica, para as reabsorções dentárias, para que o diagnóstico seja objetivo e imediatamente ligado à causa do problema, levando automaticamente o clínico ao provável plano de tratamento e a um prognóstico preciso. Com esse objetivo, sugerimos agrupar cada caso clínico de reabsorção dentária em um dos seguintes grupos: 1) Reabsorções radiculares pela morte dos cementoblastos, com manutenção dos restos epiteliais de Malassez. 2) Reabsorções radiculares pela morte dos cementoblastos e dos restos epiteliais de Malassez. 3) Reabsorções dentárias pela morte dos odontoblastos, com manutenção da vitalidade pulpar. 4) Reabsorções dentárias pela exposição direta da dentina ao tecido conjuntivo gengival, nos gaps da junção amelocementária.

Multiple internal resorption in permanent teeth associated with hyperparathyroidism.

Internal resorption has been described as a resorptive defect of internal aspect of tooth. It is caused by transformation of normal pulp tissue into granulomatous tissue with giant cells which resorb dentin. Though mostly idiopathic in origin, trauma, caries and restorative procedures have also been suggested to be contributing factors of internal resorption of pulp. Most of the internal resorption cases were found on isolated individual tooth. There are few case reports on multiple root resorptions. External root resorption have been frequently associated with systemic disorders like renal diseases hyperparathyroidism, rickets etc. A rare association of multiple internal resorption of permanent teeth (including lateral incisors, canines, premolars, sparing 2 nd and 3 rd . Permanent molars and missing 35,36, 42) with elevated levels of PTH and uric acid was evident in a 28 year old female patient who presented with fracture of crowns of permanent teeth. Though many cases related to dental manifestations of chronic renal disease and internal resorption of permanent teeth have been documented in literature, there is no evidence on association of hyperparathyroidism with multiple internal resorptions of teeth.

Endodontic Management Of Internal Resorptive Defect In Maxillary Central Incisor: A Case Report.

Internal resorption is a form of tooth resorption that begins at any point of pulp chamber or root canal and produce an irregular progressive removal of tooth structure. Radiographically, the lesion appears as a uniform, round-to-oval radiolucent enlargement of the pulp space. This case report presents a rare case of resorption in the middle third of pulp space in maxillary right central incisor.