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Zaccheo F, Petroni G, Fiorillo L, Heboyan A, Carnevale G, Calapaj M, Cervino G, Tallarico M. Exceptional bone remodeling over composite restoration in the management of external root resorption: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241269588. [PMID: 39140030 PMCID: PMC11320676 DOI: 10.1177/2050313x241269588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/25/2024] [Indexed: 08/15/2024] Open
Abstract
A 65-year-old Caucasian male was referred to an endodontic specialist practice in a private clinic in December 2019 for the management of an asymptomatic, radiolucent lesion located at the cervical level of the distal root of his right lower first molar, noticed during a routine periapical radiograph. After an accurate evaluation with cone-beam computed tomography (CBCT), the subgingival lesion was diagnosed as a supracrestal external cervical resorption (ECR), with a circumferential spread ⩽90°, confined to dentine without pulp involvement. The lesion was treated with the following sequence: (1) a full flap accessed the ECR, (2) the granulomatous tissue was removed from the root area, (3) the cavity was refreshed and filled with a well-refined and polished resin composite, (4) the flap was sutured at the cemento-enamel junction. A mandibular CBCT scan was performed before treatment, right after treatment, and 3 years postoperatively. Compared to the 3-year posttreatment CBCT scan, the immediate posttreatment one, revealed the absence of bone loss and an unexpected coronal bone remodeling with new bone formation over the treated lesion.
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Affiliation(s)
- Fabrizio Zaccheo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Giulia Petroni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Luca Fiorillo
- Department of Dental Research Cell, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | | | | | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Marco Tallarico
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, Rome, Italy
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Effect of a digital guide on the positional accuracy of intermaxillary fixation screw implantation in orthognathic surgery. J Plast Reconstr Aesthet Surg 2022; 75:e15-e22. [PMID: 35367159 DOI: 10.1016/j.bjps.2022.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/27/2022] [Accepted: 02/17/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Intermaxillary fixation screw (IMFS) implantation is a common procedure in orthognathic surgery (OGS) performed to the temporary maxillary-mandibular fixation and stable bite relationships. The study aims to assess the accuracy of IMFS implantation with a digital guide to reduce the occurrence of root damage. METHODS This prospective study involved 40 patients undergoing OGS at the Affiliated Hospital of Qingdao University from August 2017 to May 2021. The patients were randomly divided into two groups according to whether the IMFS implantation was with or without digital guide (20 patients in the experimental group and 20 controls). The digital guides used in the experimental group were designed according to a virtual implantation plan and printed using stereolithography. In the control group, IMFSs were directly implanted by a surgeon based on clinical experience. Postoperatively, cone-beam computed tomography was performed to compare root proximity of IMFSs between the two groups and verify the accuracy of IMFS placement. RESULTS In the experimental group, there was no case of root damage, the incidence of the periodontal ligament (PDL) injured was 22.1%, and 77.9% IMFSs were placed without contacting adjacent anatomic structures. In the control group, the incidence of root damage had been up to 20.8%, 31.7% IMFSs injured the PDL, and only 47.5% IMFSs were placed between the roots (P < 0.001). CONCLUSION IMFSs can be placed more accurately with surgical guides, reducing the incidence of root and PDL damages.
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Irinakis E, Haapasalo M, Shen Y, Aleksejuniene J. External cervical resorption - Treatment outcomes and determinants: a retrospective cohort study with up to 10 years of follow-up. Int Endod J 2022; 55:441-452. [PMID: 35243651 DOI: 10.1111/iej.13717] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/29/2022]
Abstract
AIM To assess long-term external cervical resorption (ECR) treatment outcomes in relation to both local and treatment-related determinants. METHODOLOGY Information was available for 76 patients (98 teeth) who were diagnosed with ECR during the period from 2008 to 2018 at the University of British Columbia graduate endodontics clinic. The ECR patients were followed-up, and a clinical and radiographic examination was conducted. Chi-Square test compared failure rates among different subgroups. The survival analysis was used to evaluate the overall ECR survival/failure rates in relation to several local and treatment-related determinants. RESULTS Overall, 67 patients (89 teeth) were followed-up. The mean follow-up time was 3.9 years, and the minimum was 1 year. Twenty-four teeth failed (19 extracted, 5 not functional), and the overall probability of failure was 50.0% 8 years after the diagnosis. Significant (p < 0.05) local ECR determinants were tooth location and the Heithersay classification, and treatment-related determinants were root canal treatment (RCT) and the ECR repair combined with RCT. Treatment outcomes for Heithersay class 1 and 2 cases were better than for class 3 and 4 cases. CONCLUSIONS Higher failure rates were associated with posterior tooth location and higher Heithersay class, while RCT and ECR repair combined with RCT were associated with lower failure rates.
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Affiliation(s)
- E Irinakis
- Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, Canada
| | - M Haapasalo
- Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, Canada
| | - Y Shen
- Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, Canada
| | - J Aleksejuniene
- Department of Oral Health Sciences Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
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Chen Y, Huang Y, Deng X. A Review of External Cervical Resorption. J Endod 2021; 47:883-894. [PMID: 33745945 DOI: 10.1016/j.joen.2021.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 12/21/2022]
Abstract
External cervical resorption (ECR) is a relatively uncommon yet aggressive form of dental hard tissue destruction. It is initiated at the cervical aspect of the root surface and extends apicocoronally and circumferentially inside the dentin. Despite the large number of case reports and clinical studies that have investigated ECR, its etiology remains unclear. Recent advancements in clinical assessment measures, such as the use of cone-beam computed tomographic imaging, have provided additional insights into the nature of this lesion. This has facilitated the continued development and improvement of treatment methods for this condition. In this article, we provide an overview of the latest research pertaining to the etiology, histopathology, predisposing factors, diagnosis, classification, and treatment of ECR. Furthermore, we provide a summary of the different classification schemes for ECR and highlight the relevant therapeutic principles.
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Affiliation(s)
- Yiming Chen
- Department of Geriatric Dentistry, National Medical Products Administration Key Laboratory for Dental Materials, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Laboratory of Biomedical Materials, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ying Huang
- Department of Geriatric Dentistry, National Medical Products Administration Key Laboratory for Dental Materials, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Laboratory of Biomedical Materials, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Xuliang Deng
- Department of Geriatric Dentistry, National Medical Products Administration Key Laboratory for Dental Materials, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Laboratory of Biomedical Materials, Peking University School and Hospital of Stomatology, Beijing, China.
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Irinakis E, Aleksejuniene J, Shen Y, Haapasalo M. External Cervical Resorption: A Retrospective Case-Control Study. J Endod 2020; 46:1420-1427. [DOI: 10.1016/j.joen.2020.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 05/14/2020] [Accepted: 05/30/2020] [Indexed: 02/07/2023]
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Rotondi O, Waldon P, Kim SG. The Disease Process, Diagnosis and Treatment of Invasive Cervical Resorption: A Review. Dent J (Basel) 2020; 8:dj8030064. [PMID: 32630223 PMCID: PMC7557762 DOI: 10.3390/dj8030064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 12/29/2022] Open
Abstract
Invasive cervical resorption (ICR) is a localized, subepithelial, supra-osseous resorptive process of the tooth. Although there are several predisposing factors associated with ICR, its etiology and pathogenesis are poorly understood. The damage to the protective layer on the external root surface appears to allow for the attachment of clastic cells and initiate the resorptive process, which is confined by the inner protective pericanalar resorption-resistant sheet surrounding the root canal space. The use of cone-beam computed tomography (CBCT) is recommended for the diagnosis and assessment of a resorptive lesion. Based on the thorough evaluation of the size and location of the ICR lesion using CBCT, surgical or nonsurgical treatment can be chosen to address the source of the resorption. This review discusses the current status of knowledge regarding the biology of ICR lesions as well as their external or internal treatment using hydraulic calcium silicate-based materials. Future clinical outcome studies are necessary to evaluate the impact of hydraulic calcium silicate-based materials on the healing of ICR lesions.
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Jebril A, Aljamani S, Jarad F. The Surgical Management of External Cervical Resorption: A Retrospective Observational Study of Treatment Outcomes and Classifications. J Endod 2020; 46:778-785. [DOI: 10.1016/j.joen.2020.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/27/2020] [Accepted: 03/08/2020] [Indexed: 11/17/2022]
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Newton R, Hayes J. The association of external cervical resorption with modern internal bleaching protocols: what is the current evidence? Br Dent J 2020; 228:333-337. [PMID: 32170243 DOI: 10.1038/s41415-020-1317-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Internal bleaching is an effective and minimally invasive way of bleaching non-vital teeth. A commonly cited risk associated with it is external cervical resorption (ECR), which is a potentially significant complication that could result in loss of the tooth. This is an important point of discussion with a patient during the consent process. Legally, patients are required to be made aware of material risks to which they would be likely to attach significance, such as the loss of a tooth. The risk of ECR is therefore a key component in the patient's decision-making process as they weigh it against the perceived benefits. Over the last ten years, both clinical and legal reasons have resulted in a number of changes in the materials and protocols used for internal bleaching. This leads to the question of what the current quality of evidence is regarding the association of ECR following internal bleaching with modern protocols. Other restorative options for discoloured teeth, such as veneers or crowns, involve the irreversible removal of tooth tissue and these may be chosen by patients over internal bleaching based on out-of-date evidence.
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Affiliation(s)
- Richard Newton
- Swansea Bay University Health Board, Restorative Dental Department, Morriston Hospital, Swansea, SA6 6NL, UK.
| | - Jeremy Hayes
- Swansea Bay University Health Board, Restorative Dental Department, Morriston Hospital, Swansea, SA6 6NL, UK
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Yoshpe M, Einy S, Ruparel N, Lin S, Kaufman AY. Regenerative Endodontics: A Potential Solution for External Root Resorption (Case Series). J Endod 2020; 46:192-199. [DOI: 10.1016/j.joen.2019.10.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/14/2019] [Accepted: 10/23/2019] [Indexed: 12/31/2022]
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Pettiette MT, Zhang S, Moretti AJ, Kim SJ, Naqvi AR, Nares S. MicroRNA Expression Profiles in External Cervical Resorption. J Endod 2019; 45:1106-1113.e2. [PMID: 31351582 DOI: 10.1016/j.joen.2019.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/06/2019] [Accepted: 06/05/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION External cervical resorption (ECR) has been challenging for its diagnosis, prevention, and treatment. Its etiology and pathogenesis are largely unknown. This study characterized microRNA (miRNA) expression patterns of human tissues from ECR lesions and identified potential messenger RNA targets and pathways. METHODS Granulomatous tissues from ECR (n = 5) and their adjacent nonaffected asymptomatic gingival connective tissues (n = 5) were collected. Similarly, chronic periodontitis (CP) and control samples were collected (n = 3). Quantitative reverse transcription polymerase chain reaction array analysis compared the expression profiles of 88 miRNAs between diseases. Differentially expressed miRNAs were identified using the Student t test. Bioinformatics for messenger RNA (miRWalk) and KEGG pathway analyses were performed to identify predicted target genes and biological/cellular functions and signaling pathways. RESULTS Three miRNAs (miR-20a-5p, miR-210-3p, and miR-99a-4p) were significantly down-regulated and 1 miRNA (miR-122-5p) was significantly up-regulated in ECR (P < .05). One up-regulated and 1 down-regulated miRNA reached the significance threshold in CP. A comparison of miRNA expression in ECR and CP identified 3 differentially expressed miRNAs, indicating differences in disease pathobiology. Inflammation-associated Wnt, PI3K-Akt, mitogen-activated protein kinases signaling, and bone formation-associated transforming growth factor beta pathways were identified and predicted to be modulated by differentially expressed miRNAs in both ECR and CP. Biological processes unique to each disease entity were identified, such as T- and B-cell receptor signaling pathways, osteoclast differentiation, and extracellular matrix-receptor interaction for CP. Glycosaminoglycan biosynthesis, mineral absorption, and insulin signaling pathways for ECR were identified. CONCLUSIONS This proof-of-principle in vivo study indicated that ECR has both common and unique miRNA expression profiles in comparison with CP, which are predicted to target genes regulating inflammation, immunity, and metabolism of mineralized tissues.
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Affiliation(s)
- Mary T Pettiette
- Department of Endodontics, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Shaoping Zhang
- Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, Iowa.
| | - Antonio J Moretti
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Steven J Kim
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Afsar R Naqvi
- Mucosal Immunology Laboratory, Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois
| | - Salvador Nares
- Mucosal Immunology Laboratory, Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois
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Tunçer Nİ, Köseoğlu-Seçgin C, Arman-Özçırpıcı A. An unusual case of invasive cervical resorption after piezosurgery-assisted en masse retraction. Am J Orthod Dentofacial Orthop 2019; 156:137-147. [PMID: 31256827 DOI: 10.1016/j.ajodo.2019.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 02/01/2019] [Accepted: 02/01/2019] [Indexed: 11/30/2022]
Abstract
A 16-year-old patient sought orthodontic correction for profile improvement and labially inclined maxillary incisors. She had Class II malocclusion, protrusive maxillary and mandibular incisors, and increased overjet and overbite with an American Board of Orthodontics discrepancy index value of 25. She was treated with maxillary premolar extractions and miniscrew-supported en masse retraction assisted with piezoincisions. Extraction spaces (7.5 mm per side) were closed with maximum anchorage in 10 months. Total treatment time was 23 months. Twenty-seven months after debonding, a pink spot was noted at the buccocervial region of the left central incisor. Radiographic evaluation on cone-beam computed tomographic scans revealed a severe case of invasive cervical resorption on both central incisors, around which the piezosurgical cuts had been made. Treatment proceeded with a nonintervention approach and the affected teeth were reinforced with a lingual retainer.
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Affiliation(s)
- Nilüfer İrem Tunçer
- Department of Orthodontics, Faculty of Dentistry, Başkent University, Ankara, Turkey.
| | - Cansu Köseoğlu-Seçgin
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Başkent University, Ankara, Turkey
| | - Ayça Arman-Özçırpıcı
- Department of Orthodontics, Faculty of Dentistry, Başkent University, Ankara, Turkey
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Vilela ABF, Soares PBF, Almeida GA, Veríssimo C, Rodrigues MP, Versluis A, Soares CJ. Three‐dimensional finite element stress analysis of teeth adjacent to a traumatized incisor. Dent Traumatol 2018; 35:128-134. [DOI: 10.1111/edt.12453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/16/2018] [Accepted: 11/17/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Andomar B. F. Vilela
- Department of Operative Dentistry and Dental MaterialsSchool of DentistryFederal University of Uberlândia Uberlândia Minas Gerais Brazil
| | - Priscilla B. F. Soares
- Department of Periodontology and ImplantologySchool of DentistryFederal University of Uberlândia Minas Gerais Brazil
| | - Guilherme A. Almeida
- Department of OrthodonitcsSchool of DentistryFederal University of Uberlândia Minas Gerais Brazil
| | - Crisnicaw Veríssimo
- Department of Operative Dentistry and Dental MaterialsSchool of DentistryFederal University of Goiás Goiás Brazil
| | - Monise P. Rodrigues
- Department of Operative Dentistry and Dental MaterialsSchool of DentistryFederal University of Uberlândia Uberlândia Minas Gerais Brazil
| | - Antheunis Versluis
- Department of Bioscience ResearchUniversity of Tennessee Health Science CenterCollege of Dentistry Memphis Tennessee
| | - Carlos J. Soares
- Department of Operative Dentistry and Dental MaterialsSchool of DentistryFederal University of Uberlândia Uberlândia Minas Gerais Brazil
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Espona J, Roig E, Durán-Sindreu F, Abella F, Machado M, Roig M. Invasive Cervical Resorption: Clinical Management in the Anterior Zone. J Endod 2018; 44:1749-1754. [PMID: 30243659 DOI: 10.1016/j.joen.2018.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 01/04/2023]
Abstract
According to the high number of articles published on invasive cervical resorption (ICR), this pathology, as commonly believed, is a more frequent form of cervical resorption. ICR is often misdiagnosed as internal resorption or caries, which leads to inappropriate treatment and even unnecessary tooth loss. Despite a correct diagnosis, the treatment of this type of hyperplastic invasive external resorption poses a challenge for the clinician. The Heithersay classification and the use of cone-beam computed tomographic imaging have increased our knowledge of the pathology and helped improve its prognosis. Nevertheless, there is no standard protocol for the treatment of this type of lesion. This article proposes a treatment protocol for ICR based on the pattern and location of resorption. Three treatment approaches (internal access, external access, and intentional replantation) are presented through 3 clinical cases.
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Affiliation(s)
- José Espona
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Elena Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Francesc Abella
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Manoel Machado
- Department of Endodontics, Universidade de São Paulo, São Paulo, Brazil
| | - Miguel Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain.
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Shemesh A, Birnboim‐Blau G, Zoizner R, Itzhak JB, Solomonov M. External invasive resorption: Case report of a rapidly progressive process in an impacted maxillary canine during orthodontic treatment. AUST ENDOD J 2018; 45:259-264. [DOI: 10.1111/aej.12293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Avi Shemesh
- Department of Endodontics Israel Defense Forces (IDF) Medical Corps Ramat Gan Israel
| | - Galit Birnboim‐Blau
- Department of Orthodontics Israel Defense Forces (IDF) Medical Corps Ramat Gan Israel
| | - Ronen Zoizner
- Department of Orthodontics Israel Defense Forces (IDF) Medical Corps Ramat Gan Israel
| | - Joe Ben Itzhak
- Department of Endodontics Israel Defense Forces (IDF) Medical Corps Ramat Gan Israel
| | - Michael Solomonov
- Department of Endodontics Israel Defense Forces (IDF) Medical Corps Ramat Gan Israel
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15
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Patel S, Foschi F, Mannocci F, Patel K. External cervical resorption: a three-dimensional classification. Int Endod J 2017; 51:206-214. [DOI: 10.1111/iej.12824] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 07/23/2017] [Indexed: 12/01/2022]
Affiliation(s)
- S. Patel
- Postgraduate Endodontic Unit; King's College Dental Institute; London UK
| | - F. Foschi
- Postgraduate Endodontic Unit; King's College Dental Institute; London UK
| | - F. Mannocci
- Postgraduate Endodontic Unit; King's College Dental Institute; London UK
| | - K. Patel
- Postgraduate Endodontic Unit; King's College Dental Institute; London UK
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Velloso GR, de Freitas MM, Alves ATNN, Silva ARS, Barboza ESP, Moraschini V. Multiple external cervical root resorptions after home whitening treatment: a case report. Aust Dent J 2017. [DOI: 10.1111/adj.12540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- GR Velloso
- School of Dentistry; Unigranrio University; Rio de Janeiro Brazil
| | - MM de Freitas
- School of Dentistry; Unigranrio University; Rio de Janeiro Brazil
| | - ATNN Alves
- Department of Pathology; School of Dentistry; Federal Fluminense University; Niterói Brazil
| | - ARS Silva
- Departments of Oral Diagnosis and Pathology; School of Dentistry; University of Campinas; São Paulo Brazil
| | - ESP Barboza
- Department of Periodontology; School of Dentistry; Federal Fluminense University; Niterói Brazil
| | - V Moraschini
- School of Dentistry; Federal Fluminense University; Niterói Brazil
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Soares AJ, Souza GA, Pereira AC, Vargas-Neto J, Zaia AA, Silva EJNL. Frequency of root resorption following trauma to permanent teeth. J Oral Sci 2017; 57:73-8. [PMID: 26062854 DOI: 10.2334/josnusd.57.73] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This retrospective study evaluated the frequency of development of root resorption in dental trauma cases involving supporting tissue. For 249 traumatized teeth of 125 patients aged between 7 and 51 years, we collected data on the gender and age of the patient, the teeth involved, the type of trauma, and the period between dental injury and initial examination. Radiographic parameters examined in relation to root resorption included the presence of inflammatory external root resorption, internal root resorption, replacement resorption, and canal calcification. Data were analyzed by chi-squared test, Fisher's exact test, and mult iple logistic regression (P < 0.05). The results indicated that there was a significant relationship between the period from the date of injury until initial examination and the occurrence of inflammatory external resorption (P = 0.0199), as well as the type of injury (P = 0.0406). Furthermore, external resorption was most frequently associated with intrusive luxation (92.8%), followed by avulsion (89.0%), lateral luxation (80.2%), and extrusive luxation (77.4%). Among the types of dental injury, replacement resorption was observed more frequently in cases of avulsion (87.2%). The only factor that was significantly associated with this type of resorption was the type of injury (P < 0.0001). Root resorption is observed more frequently and its risk of development is higher in cases of severe trauma, especially avulsion and intrusive luxation.
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Affiliation(s)
- Adriana J Soares
- Department of Restorative Dentistry, Endodontics Area, State University of Campinas
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Tsaousoglou P, Markou E, Efthimiades N, Vouros I. Characteristics and treatment of invasive cervical resorption in vital teeth. A narrative review and a report of two cases. Br Dent J 2017; 222:423-428. [PMID: 28336998 DOI: 10.1038/sj.bdj.2017.263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2017] [Indexed: 11/09/2022]
Abstract
Invasive cervical resorption (ICR) is a significant defect of the root surface where the hard dental tissues are undermined and become translucent due to the resorptive granulomatous tissue. It is mainly detected on radiographs. The radiographic appearance of ICR is asymmetrical radiolucency with irregular margins and an unchanged root canal. The purpose of this study is to present a comprehensive review together with the characteristics and the treatment of ICR through two cases which were followed-up for 36 months. In both cases the teeth were vital and the management consisted of raising a flap, granulomatous tissue removal, thorough debridement, restoration of the resorptive defect by placing a suitable filling material and follow-up examinations. Our results indicate that the specific treatment protocol has very positive outcomes. After 36 months pulpal vitality tests revealed a healthy pulp, and clinical and radiographic examination confirmed a stable periodontal condition.
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Affiliation(s)
- P Tsaousoglou
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | | | - N Efthimiades
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - I Vouros
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
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Mavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding external cervical resorption patterns in endodontically treated teeth. Int Endod J 2017; 50:1116-1133. [DOI: 10.1111/iej.12744] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/11/2017] [Indexed: 01/30/2023]
Affiliation(s)
- A.-M. Mavridou
- Department of Oral Health Sciences; BIOMAT Research Cluster; KU Leuven & University Hospital Leuven; Leuven Belgium
- Private Practice; Endo Rotterdam; Rotterdam the Netherlands
| | - E. Hauben
- Department of Imaging and Pathology; KU Leuven & University Hospitals Leuven; Leuven Belgium
| | - M. Wevers
- Department of Materials Engineering (MTM); KU Leuven & University Hospitals Leuven; Leuven Belgium
| | - E. Schepers
- Department of Oral Health Sciences; BIOMAT Research Cluster; KU Leuven & University Hospital Leuven; Leuven Belgium
| | - L. Bergmans
- Department of Oral Health Sciences; BIOMAT Research Cluster; KU Leuven & University Hospital Leuven; Leuven Belgium
| | - P. Lambrechts
- Department of Oral Health Sciences; BIOMAT Research Cluster; KU Leuven & University Hospital Leuven; Leuven Belgium
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Vaz de Souza D, Schirru E, Mannocci F, Foschi F, Patel S. External Cervical Resorption: A Comparison of the Diagnostic Efficacy Using 2 Different Cone-beam Computed Tomographic Units and Periapical Radiographs. J Endod 2017; 43:121-125. [DOI: 10.1016/j.joen.2016.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/01/2016] [Accepted: 09/04/2016] [Indexed: 10/20/2022]
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21
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Mavridou AM, Hauben E, Wevers M, Schepers E, Bergmans L, Lambrechts P. Understanding External Cervical Resorption in Vital Teeth. J Endod 2016; 42:1737-1751. [DOI: 10.1016/j.joen.2016.06.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/04/2016] [Accepted: 06/09/2016] [Indexed: 12/31/2022]
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Baranwal AK. Management of external invasive cervical resorption of tooth with Biodentine: A case report. J Conserv Dent 2016; 19:296-9. [PMID: 27217649 PMCID: PMC4872590 DOI: 10.4103/0972-0707.181952] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Invasive cervical resorption (ICR) of a tooth is relatively uncommon and the etiology is not very clear. It is sometimes misdiagnosed and can lead to improper management or tooth loss. Correct diagnosis and proper management can result in a successful outcome. The treatment should aim toward the complete suppression of all resorbing tissues and the reconstruction of resorptive defect by the placement of a suitable filling material or some biological systems. One of the most significant developments of the past decade, i.e. the operating microscope used for surgical endodontics, helps the surgeon to assess pathological changes more precisely and to remove pathological lesions with far greater precision, thus minimizing tissue damage. The aim of this article was to show the management of maxillary left central incisor diagnosed with external ICR using Biodentine under dental operatory microscope (DOM).
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Affiliation(s)
- Akash Kumar Baranwal
- Department of Conservative Dentistry and Endodontics, Institute of Medical Sciences (IMS), Banaras Hindu University (BHU), Varanasi, Uttar Pradesh, India
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23
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Patel K, Foschi F, Pop I, Patel S, Mannocci F. The Use of Intentional Replantation to Repair an External Cervical Resorptive Lesion Not Amenable to Conventional Surgical Repair. Prim Dent J 2016; 5:78-83. [PMID: 28826436 DOI: 10.1308/205016816819304213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Intentional replantation consists of purposefully extracting a tooth, correcting the defect and replanting it into its original socket. This case report describes how this technique was used to successfully restore an external cervical resorptive (ECR) lesion. A 22-year-old man was diagnosed with ECR of the mandibular right canine following clinical and radiographic examination. CBCT showed the lesion had been initiated distally and extended circumferentially around the root canal. The nature of the resorptive lesion meant that it was inaccessible to repair conventionally in a predictable manner. This report describes how intentional replantation was used to access and restore the lesion with minimal patient cooperation and postoperative discomfort. At an 18-month recall the tooth was clinically sound with no radiographic evidence of inflammatory or replacement root resorption. Intentional replantation should be considered a viable treatment option when ECR is inaccessible and cannot be restored using conventional techniques.
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Affiliation(s)
- Kreena Patel
- Department of Endodontology, Kings College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK
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24
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Kumar SS, Kumar NSM, Karunakaran JV, Nagendran S. Management of invasive cervical resorption in a maxillary central incisor. J Pharm Bioallied Sci 2015; 7:S712-7. [PMID: 26538950 PMCID: PMC4606692 DOI: 10.4103/0975-7406.163494] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Invasive cervical resorption is often not diagnosed properly, leading to improper treatment or unnecessary loss of the tooth structure. Early diagnosis and appropriate treatment are the keys to a successful outcome of therapy. Invasive cervical resorption is often seen in the cervical area of the tooth, but because it is initiated apical to the epithelial attachment, it can present anywhere in the root. In the early stages, it may be symmetrical, but larger lesions have the tendency to be asymmetrical. It can expand apically or coronally.
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Affiliation(s)
- S Senthil Kumar
- Department of Conservative Dentistry and Endodontics, J. K. K. Nattraja Dental College, Komarapalayam, Tamil Nadu, India
| | - N S Mohan Kumar
- Department of Conservative Dentistry and Endodontics, J. K. K. Nattraja Dental College, Komarapalayam, Tamil Nadu, India
| | - J V Karunakaran
- Department of Conservative Dentistry and Endodontics, J. K. K. Nattraja Dental College, Komarapalayam, Tamil Nadu, India
| | - S Nagendran
- Department of Conservative Dentistry and Endodontics, J. K. K. Nattraja Dental College, Komarapalayam, Tamil Nadu, India
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25
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Torres-Rodríguez C, Portolés MT, Matesanz MC, Linares J, Feito MJ, Izquierdo-Barba I, Esbrit P, Vallet-Regí M. Effects of bleaching on osteoclast activity and their modulation by osteostatin and fibroblast growth factor 2. J Colloid Interface Sci 2015; 461:285-291. [PMID: 26407056 DOI: 10.1016/j.jcis.2015.09.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/10/2015] [Accepted: 09/11/2015] [Indexed: 02/06/2023]
Abstract
HYPOTHESIS Dental bleaching with H2O2 is a common daily practice in dentistry to correct discoloration of anterior teeth. The aim of this study has been to determine whether this treatment of human teeth affects growth, differentiation and activity of osteoclast-like cells, as well as the putative modulatory action of osteostatin and fibroblast growth factor 2 (FGF-2). EXPERIMENTS Previously to the in vitro assays, structural, physical-chemical and morphological features of teeth after bleaching were studied. Osteoclast-like cells were cultured on human dentin disks, pre-treated or not with 38% H2O2 bleaching gel, in the presence or absence of osteostatin (100 nM) or FGF-2 (1 ng/ml). Cell proliferation and viability, intracellular content of reactive oxygen species (ROS), pro-inflammatory cytokine (IL-6 and TNFα) secretion and resorption activity were evaluated. FINDINGS Bleaching treatment failed to affect either the structural or the chemical features of both enamel and dentin, except for slight morphological changes, increased porosity in the most superficial parts (enamel), and a moderate increase in the wettability degree. In this scenario, bleaching produced an increased osteoclast-like cell proliferation but decreased cell viability and cytokine secretion, while it augmented resorption activity on dentin. The presence of either osteostatin or FGF-2 reduced the osteoclast-like cell proliferation induced by bleaching. FGF-2 enhanced ROS content, whereas osteostatin decreased ROS but increased TNFα secretion. The bleaching effect on resorption activity was increased by osteostatin, but this effect was less evident with FGF-2. CONCLUSIONS These findings further confirm the deleterious effects of tooth bleaching by affecting osteoclast growth and function as well as different modulatory actions of osteostatin and FGF-2.
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Affiliation(s)
- Carolina Torres-Rodríguez
- Departamento de Salud Oral, Facultad de Odontología, Universidad Nacional de Colombia, Sede Bogotá, Colombia.
| | - M Teresa Portolés
- Departamento de Bioquímica y Biología Molecular I, Facultad de Ciencias Químicas, Universidad Complutense, Madrid, Spain.
| | - M Concepción Matesanz
- Departamento de Bioquímica y Biología Molecular I, Facultad de Ciencias Químicas, Universidad Complutense, Madrid, Spain.
| | - Javier Linares
- Departamento de Bioquímica y Biología Molecular I, Facultad de Ciencias Químicas, Universidad Complutense, Madrid, Spain.
| | - M José Feito
- Departamento de Bioquímica y Biología Molecular I, Facultad de Ciencias Químicas, Universidad Complutense, Madrid, Spain.
| | - Isabel Izquierdo-Barba
- Departamento de Química Inorgánica y Bioinorgánica, Facultad de Farmacia, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubrei+12, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
| | - Pedro Esbrit
- Laboratorio de Metabolismo Mineral y Óseo, Instituto de Investigación Sanitaria (IIS)-Fundación Jiménez Díaz, Madrid, Spain.
| | - María Vallet-Regí
- Departamento de Salud Oral, Facultad de Odontología, Universidad Nacional de Colombia, Sede Bogotá, Colombia; Departamento de Bioquímica y Biología Molecular I, Facultad de Ciencias Químicas, Universidad Complutense, Madrid, Spain; Departamento de Química Inorgánica y Bioinorgánica, Facultad de Farmacia, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubrei+12, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain.
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Abstract
PRACTICAL RELEVANCE Tooth resorption is common in the domestic cat and the incidence has been reported to increase with increasing age. Cats with clinically missing teeth have also been found to be more likely to have tooth resorption. All types of teeth in the feline dentition may be affected, but lesions seem to be more common in certain teeth. CLINICAL CHALLENGES Tooth resorption can be difficult to detect, with cats often masking signs of oral discomfort or pain. Routine radiography is required for timely diagnosis, as clinical (visual and tactile) methods only detect late-stage lesions - that is, when they become evident in the crown. The aetiology of many tooth resorptions is not clear. A large number of lesions appear to be idiopathic and, to date, there is no known treatment that prevents the development and/or progression of this category of tooth resorption. Tooth extraction is the gold standard treatment but teeth with resorptive lesions are notoriously difficult to extract and coronal amputation is often indicated. Determining the best treatment option in an individual case again relies on radiography. AUDIENCE This review is aimed at feline and general practitioners, as well as veterinarians with expertise in dentistry. EVIDENCE BASE The author draws on the published literature and her clinical experience and own research to review current thinking about the epidemiology, aetiology and pathogenesis of tooth resorptions, and to offer advice on diagnosis and treatment options.
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Affiliation(s)
- Cecilia Gorrel
- European and RCVS recognised specialist in veterinary dentistry 17 Burnt House Lane, Pilley, Hampshire SO41 5QN, UK
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Bharti R, Chandra A, Tikku AP, Prasad V, Shakya VK, Singhal R. Management of mucosal fenestration with external root resorption by multidisciplinary approach. BMJ Case Rep 2014; 2014:bcr-2014-206259. [PMID: 25301425 DOI: 10.1136/bcr-2014-206259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mucosal fenestration is a clinical condition in which the overlying gingiva is denuded and the root is exposed to the oral cavity. Invasive cervical resorption is an entirely uncommon entity and its aetiology is poorly understood. This case presents an invasive cervical resorption of maxillary right central incisor with fenestration at the cervical third of the tooth. The resorption area was chemomechanically debrided. It was then restored with Mineral Trioxide Aggregate over which pink glass ionomer cement (GC Fuji VII) was placed. Lateral pedicle flap was used to cover the fenestration. The resorptive defect was restored using tooth coloured restorative resin after removal of the pink glass ionomer cement. Orthodontic treatment was continued for correction of malocclusion.
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Affiliation(s)
- Ramesh Bharti
- Faculty of Dental Sciences, Department of Conservative Dentistry and Endodontics, King George's Medical University Lucknow, Lucknow, Uttar Pradesh, India
| | - Anil Chandra
- Faculty of Dental Sciences, Department of Conservative Dentistry and Endodontics, King George's Medical University Lucknow, Lucknow, Uttar Pradesh, India
| | - Aseem Prakash Tikku
- Faculty of Dental Sciences, King George's Medical University Lucknow, Lucknow, Uttar Pradesh, India
| | - Veerendra Prasad
- Department of Plastic Surgery, King George's Medical University Lucknow, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar Shakya
- Faculty of Dental Sciences, Department of Conservative Dentistry and Endodontics, King George's Medical University Lucknow, Lucknow, Uttar Pradesh, India
| | - Rameshweri Singhal
- Faculty of Dental Sciences, Department of Periodontology, King George's Medical University Lucknow, Lucknow, Uttar Pradesh, India
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29
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Bal MV, Yıldırım Ş, Saygun I. A case report of gingival enlargement associated with invasive cervical resorption. Oper Dent 2014; 40:117-22. [PMID: 25136907 DOI: 10.2341/13-267-s] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Invasive cervical resorption (ICR) is a rare external dental resorption with unknown etiology; it progresses asymptomatically in the cervical area of the permanent teeth. Lesions are mostly misdiagnosed as internal resorption or caries, which leads to erroneous treatments. This case report presents the clinical and radiological diagnosis, as well as the results of treatment and 3-year follow-up in a 50-year-old female patient with gingival enlargement associated with ICR in tooth No. 25. Granulation tissue was removed by accessing the cervical resorption area through a flap operation. Following the endodontic treatment, the tooth was restored using composite resin and the hyperplastic lesion was excised. In conclusion, it should be kept in mind that clinical, radiological, and pathological evaluation in the differential diagnosis of localized hyperplastic lesions in the gingiva is of importance and that ICR could play a role in the etiology of these lesions.
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30
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Kamat M, Puranik R, Vanaki S, Kamat S. An insight into the regulatory mechanisms of cells involved in resorption of dental hard tissues. J Oral Maxillofac Pathol 2014; 17:228-33. [PMID: 24250084 PMCID: PMC3830232 DOI: 10.4103/0973-029x.119736] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Dental resorptions constitute a challenge to dentistry due to the complexity of cellular and molecular biology. The various cells involved in resorption, collectively orchestrate the interplay between various cytokines, hormones, enzymes, and hard tissues influencing the progression of resorption. The concern and curiosity on this subject are not new. This paper attempts to review the various regulatory mechanisms of cells involved in resorption of mineralized dental tissues.
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Affiliation(s)
- Mamata Kamat
- Department of Oral and Maxillofacial Pathology, Modern Dental College and Hospital, Gandhinagar, Indore, India
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31
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Ahmed N, Gopalakrishnan, Mony B, Parthasarthy H. External cervical resorption case report and a brief review of literature. J Nat Sci Biol Med 2014; 5:210-4. [PMID: 24678232 PMCID: PMC3961940 DOI: 10.4103/0976-9668.127336] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
External cervical resorption (ECR) is the loss of dental hard tissue as a result of odontoclastic action; it usually begins on the cervical region of the root surface of the teeth. The etiology, predisposing factors, diagnosis, and management of ECR have been reviewed here. Effective management and appropriate treatment can only be carried out if the true nature and exact location of the ECR lesion are known. This paper reports on the management of a case of external cervical root resorption (ECRR), which involved root canal treatment and removal of the resorbing area of the affected tooth as well as filling the resorbed area with mineral trioxide aggregate (MTA) and resin-modified glass ionomer filling material (RMGIC). The defect was filled with bone graft material and guided tissue regeneration (GTR) membrane. This case highlights the importance of using MTA and successful management of cervical resorption with a stable uneventful clinical recovery.
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Affiliation(s)
- Nizar Ahmed
- Department of Periodontics,Thai Moogambigai Dental College, Mugappair, Chennai, India
| | - Gopalakrishnan
- Department of Periodontics,Thai Moogambigai Dental College, Mugappair, Chennai, India
| | - Bejoy Mony
- Department of Endodontics, SRM Dental College,Ramapuram, Chennai, India
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32
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SK AS, O O. The diagnosis and management of invasive cervical resorption. ACTA ACUST UNITED AC 2013; 40:412-4, 417-8. [DOI: 10.12968/denu.2013.40.5.412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Al-Salehi SK
- Associate Professor/Consultant Restorative Dentistry, European University College, Dubai Health Care City, Ibn Sina Building No 27, Block D, 3rd Floor, Office 302, Dubai, UAE
| | - Omar O
- School of Dentistry, The University of Manchester, Coupland 3 Building, Coupland Street, Manchester M13 5PL, UK
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Gunst V, Mavridou A, Huybrechts B, Van Gorp G, Bergmans L, Lambrechts P. External cervical resorption: an analysis using cone beam and microfocus computed tomography and scanning electron microscopy. Int Endod J 2013; 46:877-87. [DOI: 10.1111/iej.12073] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 01/12/2013] [Indexed: 11/29/2022]
Affiliation(s)
- V. Gunst
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - A. Mavridou
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - B. Huybrechts
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - G. Van Gorp
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - L. Bergmans
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
| | - P. Lambrechts
- Department of Oral Health Sciences; Section Endodontics; BIOMAT Research Cluster; KU; Leuven; Belgium
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34
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Management of external invasive cervical resorption tooth with mineral trioxide aggregate: a case report. Case Rep Med 2013; 2013:139801. [PMID: 23476658 PMCID: PMC3586436 DOI: 10.1155/2013/139801] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 01/03/2013] [Indexed: 12/03/2022] Open
Abstract
Invasive cervical resorption is entirely uncommon entities and the etiology is poorly understood. A 19 year old patient presented with fractured upper left central incisor and sinus tract opening on the distobuccal aspect in cervical region. Radiographic examination shows irregular radiolucency over the coronal one-third and it extended externally towards the external invasive resorption. After sectional obturation, the defect was accessed surgically. The resorption area was chemomechanically debrided using irrigant solution. Fibre post placement using flowable composite resin and Mineral Trioxide Aggregate (MTA) was used to fill the resorptive defect, and the coronal access was temporarily sealed. Composite restoration was subsequently replaced with ceramic crown after 4 years. Radiographs at 1 and 4 years showed adequate repair of the resorption and endodontic success. Clinically and radiographically the tooth was asymptomatic, and no periodontal pocket was found after a 4-year followup.
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35
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Thönen A, Peltomäki T, Patcas R, Zehnder M. Occurrence of Cervical Invasive Root Resorption in First and Second Molar Teeth of Orthodontic Patients Eight Years after Bracket Removal. J Endod 2013; 39:27-30. [DOI: 10.1016/j.joen.2012.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 08/10/2012] [Accepted: 08/21/2012] [Indexed: 11/16/2022]
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36
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Alves TP, Soares TRC, Barreto SC, Fried H, Pereira GDS, Maia LC, Santos AEC. Multidisciplinary approach for the treatment of extensive external cervical resorption after dental trauma. Oper Dent 2012; 38:349-57. [PMID: 23210917 DOI: 10.2341/12-278-s] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
External cervical resorption (ECR) is a sequela of dentoalveolar trauma that may cause functional, esthetic, and psychologic alterations. The aim of this study was to report a successful multidisciplinary treatment approach performed in a 12-year-old patient who presented with posttraumatic ECR associated with extensive opened cavity, pulp necrosis, and periapical lesion of tooth number 9, with an initial unfavorable prognosis. Crown lengthening was done to enable restoration of vestibular surface with resin composite, forming a barrier that allowed endodontic treatment. Afterwards, a prefabricated fiberglass post was cemented and esthetic restoration was performed using the adhesive technique and direct composite veneer. Reconstructive periodontal surgery was performed to correct irregular gingival contour. After treatment and successive follow-up sessions, it was concluded that although the tooth had been indicated for extraction, low invasive direct techniques were effective to recover function and esthetics and to maintain the tooth in the oral cavity.
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Affiliation(s)
- T P Alves
- School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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37
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Kqiku L, Ebeleseder KA, Glockner K. Treatment of invasive cervical resorption with sandwich technique using mineral trioxide aggregate: a case report. Oper Dent 2011; 37:98-106. [PMID: 21942289 DOI: 10.2341/11-143-s] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This article presents two cases of large invasive cervical resorption (ICR) with maintenance of pulp vitality after treatment with mineral trioxide aggregate (MTA) in a sandwich technique.Invasive cervical resorption is a relatively uncommon but aggressive form of external resorption, primarily caused by dental trauma or injury of the cervical periodontal attachment. The resorptive process does not penetrate into the root canal, and the pulp is not involved in the first phase of the resorption. This feature differentiates external resorption from internal resorption. In most cases, invasive cervical resorption is found during routine radiographic or clinical examination. Different materials have been proposed for the treatment of external cervical resorption. Therapy can be effective when it 1) removes the etiological factors and 2) interrupts the progressive resorption mechanism.The key learning points of this article are the following: treatment strategy to arrest the cervical resorption process and to prevent further resorption without changing pulpal vitality and successful seal of invasive cervical resorption defect using MTA with a sandwich technique.
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Affiliation(s)
- L Kqiku
- Department of Dentistry and Maxillofacial Surgery, Medical University, Graz, Austria.
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38
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Gunst V, Huybrechts B, De Almeida Neves A, Bergmans L, Van Meerbeek B, Lambrechts P. Playing wind instruments as a potential aetiologic cofactor in external cervical resorption: two case reports. Int Endod J 2010; 44:268-82. [DOI: 10.1111/j.1365-2591.2010.01822.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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39
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Estevez R, Aranguren J, Escorial A, de Gregorio C, De La Torre F, Vera J, Cisneros R. Invasive Cervical Resorption Class III in a Maxillary Central Incisor: Diagnosis and Follow-up by Means of Cone-Beam Computed Tomography. J Endod 2010; 36:2012-4. [DOI: 10.1016/j.joen.2010.08.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Revised: 07/06/2010] [Accepted: 08/06/2010] [Indexed: 11/16/2022]
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40
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Case report: endodontic and surgical treatment of an upper central incisor with external root resorption and radicular cyst following a traumatic tooth avulsion. ACTA ACUST UNITED AC 2010; 110:e61-7. [DOI: 10.1016/j.tripleo.2010.04.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Revised: 04/06/2010] [Accepted: 04/20/2010] [Indexed: 11/23/2022]
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41
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Patel S, Kanagasingam S, Pitt Ford T. External cervical resorption: a review. J Endod 2009; 35:616-25. [PMID: 19410071 DOI: 10.1016/j.joen.2009.01.015] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2008] [Revised: 01/23/2009] [Accepted: 01/28/2009] [Indexed: 12/24/2022]
Abstract
External cervical resorption (ECR) is the loss of dental hard tissue as a result of odontoclastic action; it usually begins on the cervical region of the root surface of the teeth. The etiology, predisposing factors, diagnosis, and management of ECR are reviewed. Effective management and appropriate treatment can only be carried out if the true nature and exact location of the ECR lesion are known. The role of cone beam computed tomography as a diagnostic adjunct for the management of ECR is also reviewed.
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Affiliation(s)
- Shanon Patel
- Endodontic Postgraduate Unit, King's College London Dental Institute, London, UK.
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Kirakozova A, Teixeira FB, Curran AE, Gu F, Tawil PZ, Trope M. Effect of Intracanal Corticosteroids on Healing of Replanted Dog Teeth after Extended Dry Times. J Endod 2009; 35:663-7. [DOI: 10.1016/j.joen.2009.01.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 01/18/2009] [Accepted: 01/28/2009] [Indexed: 12/24/2022]
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Effects of intentional damage of the roots and surrounding structures with miniscrew implants. Am J Orthod Dentofacial Orthop 2009; 135:280.e1-9; discussion 280-1. [PMID: 19268823 DOI: 10.1016/j.ajodo.2008.06.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 06/09/2008] [Accepted: 06/09/2008] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The purposes of the study were to evaluate the immediate damage to roots and periodontal structures after initial miniscrew implant (MSI) placement and the short- and long-term damage after MSIs were left in situ. METHODS The roots of the maxillary second, third, and fourth premolars of 7 mature beagle dogs were randomly assigned to undergo immediate, short-term (left for 6 weeks), or long-term (left for 12 weeks) damage. Intentional damage was inflicted with self-tapping screws (1.8 x 8 mm) placed with a stent. Alternating tetracycline and calcein labels were administered at 6-week intervals. Undecalcified sections were stained and evaluated histologically to determine the extent of damage; healing was evaluated by using fluorescence labels. RESULTS Histology showed damage to 73.8% of the teeth, ranging from displacement of bone into the periodontal ligament to invasion of the pulp chamber. Displacement of bone into the periodontal ligament and direct damage to the periodontal ligament occurred in 3 (7.2%) instances. Damage was isolated to the cementum of 8 (19.0%) teeth, whereas damage occurred in the dentin of 11 (26.2%) teeth. Loss of bone in the furcation was evident in 3 (7.2%) teeth, and severe damage into the pulp occurred in 6 (14.2%) teeth. No differences in the amounts of damage were evident between the immediate, short-, and long-term groups. Healing often occurred with cementum around the unloaded MSIs. CONCLUSIONS Extensive damage can be caused by MSIs, with little to no differences evident over time. Unloaded MSIs that remain in contact with roots of teeth can show varying degrees of healing.
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Staszyk C, Bienert A, Kreutzer R, Wohlsein P, Simhofer H. Equine odontoclastic tooth resorption and hypercementosis. Vet J 2008; 178:372-9. [DOI: 10.1016/j.tvjl.2008.09.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2008] [Indexed: 01/09/2023]
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Mattar R, de Lima Pereira SA, Rodor RC, Rodrigues DBR. External multiple invasive cervical resorption with subsequent arrest of the resorption. Dent Traumatol 2008; 24:556-9. [DOI: 10.1111/j.1600-9657.2007.00553.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Beertsen W, Piscaer M, Van Winkelhoff AJ, Everts V. Generalized cervical root resorption associated with periodontal disease. J Clin Periodontol 2008. [DOI: 10.1111/j.1600-051x.2001.281112.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sunitha V R, Emmadi P, Namasivayam A, Thyegarajan R, Rajaraman V. The periodontal - endodontic continuum: A review. J Conserv Dent 2008; 11:54-62. [PMID: 20142886 PMCID: PMC2813095 DOI: 10.4103/0972-0707.44046] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2007] [Revised: 09/20/2007] [Accepted: 10/04/2007] [Indexed: 11/08/2022] Open
Abstract
Periodontal therapy deals with many aspects of the supporting structures, including the prevention and repair of lesions of the gingival sulcus. Endodontics deals primarily with disease of the pulp and periapical tissues. The success of both periodontal and endodontic therapy depends on the elimination of both disease processes, whether they exist separately or as a combined lesion. The relationship between periodontal and endodontic disease has been a subject of speculation for many years. This paper aims at presenting a comprehensive review of several aspects of perio-endo lesions.
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Affiliation(s)
- Raja Sunitha V
- Department of Periodontics, Meenakshiammal Dental College and Hospital, Alapakkam Road, Maduravoyal, Chennai, India
| | - Pamela Emmadi
- Department of Periodontics, Meenakshiammal Dental College and Hospital, Alapakkam Road, Maduravoyal, Chennai, India
| | - Ambalavanan Namasivayam
- Department of Periodontics, Meenakshiammal Dental College and Hospital, Alapakkam Road, Maduravoyal, Chennai, India
| | - Ramakrishnan Thyegarajan
- Department of Periodontics, Meenakshiammal Dental College and Hospital, Alapakkam Road, Maduravoyal, Chennai, India
| | - Vijayalakshmi Rajaraman
- Department of Periodontics, Meenakshiammal Dental College and Hospital, Alapakkam Road, Maduravoyal, Chennai, India
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Nemec A, Pavlica Z, Stiblar-Martincic D, Petelin M, Erzen D, Crossley D. Histological evaluation of the pulp in teeth from dogs with naturally occurring periodontal disease. J Vet Dent 2008; 24:212-23. [PMID: 18309854 DOI: 10.1177/089875640702400402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this investigation was to evaluate the pulp of dog teeth affected by advanced periodontal disease. Histological examination was done on demineralized teeth extracted during clinical treatment of mature, client owned small and medium-size breed dogs with either good periodontal health or with advanced naturally occurring periodontal disease. Routinely stained sections from 5 clinically normal teeth and 22 teeth with advanced periodontitis from dogs between 5 and 12-years of age were examined using light microscopy. The pulp cavities of most teeth were narrow with low cellularity and some fibrosis of the pulp. Findings specific to periodontally affected teeth included acute and chronic pulpitis, vascular congestion, and pulp necrosis. A glomus body was identified in the pulp of one tooth and areas of poorly mineralized cementum were seen in both normal and diseased teeth. Age related changes in dog teeth appear similar to those reported for man and the rat. In addition to age related changes, the pulp of dog teeth with advanced periodontal disease were frequently inflamed or necrotic. This may reflect the advanced periodontitis affecting these teeth or a mechanical effect related to excessive tooth mobility. Further study is required to determine the etiology and significance of these findings and to investigate pulp status in less severely diseased teeth.
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Affiliation(s)
- Ana Nemec
- Clinic for Small Animal Medicine and Surgery, Veterinary Faculty, University of Ljubljana, Slovenia.
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Pace R, Giuliani V, Pagavino G. Mineral trioxide aggregate in the treatment of external invasive resorption: a case report. Int Endod J 2008; 41:258-66. [DOI: 10.1111/j.1365-2591.2007.01338.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chen H, Teixeira FB, Ritter AL, Levin L, Trope M. The effect of intracanal anti-inflammatory medicaments on external root resorption of replanted dog teeth after extended extra-oral dry time. Dent Traumatol 2008; 24:74-8. [DOI: 10.1111/j.1600-9657.2006.00483.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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