Multiple idiopathic apical root resorption

Multiple Idiopathic External Apical Root Resorption: A Case Report of a Rare Entity

Idiopathic root resorption is characterized by the gradual destruction of tooth roots without a clear cause; the possible underlying factors include genetic predispositions, immune system abnormalities, or environmental influences. This case report highlights an unusual instance of a 27-year-old young female patient who presented with multiple decayed teeth; the orthopantomographic examination incidentally revealed extensive root resorptions. Thorough biochemical investigations such as acid phosphatase, alkaline phosphatase, thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3), as well as calcium, were within normal limits, with no identifiable local or systemic factors, leading to a diagnosis of idiopathic root resorption. Diagnosing multiple idiopathic external apical root resorption (MIEARR) is particularly challenging, underscoring the importance of regular monitoring and comprehensive dental care to prevent further deterioration. The uniqueness of our case report lies in its investigative approach, employing advanced diagnostic techniques such as nano CT and scanning electron microscopy (SEM). It also includes a comparative analysis of cases previously reported in the literature.

The Medical, Clinical, and Radiographic Aspects of Multiple Idiopathic Tooth Resorption: A Systematic Review

Background: Many causes of resorption remain unclear and are thus identified as idiopathic. In such cases, management is difficult, especially when multiple teeth are involved. The aim of the present study was to assess the literature regarding the medical, clinical, and radiographic aspects of multiple idiopathic resorptions (MIR) and to examine the factors associated with the risk of extraction. Methods: The title and protocol were registered a priori in PROSPERO (CRD42020191564), and the study followed the PRISMA methodology. Four electronic databases were searched to include reviews and case reports on MIR in permanent dentition. Results: Among the 1035 articles identified, 31 case reports were included. The mean age of the patients was 32 years (SD = 16.4). MIR were consistently diagnosed after radiographic evaluation and were undetected during intra-oral examination in 62% of cases. The treatment involved extraction in 77% of cases. The risk of extraction increased in the presence of periodontal inflammation. Conclusions: MIR are aggressive forms of resorption requiring routine visits. MIR mostly involve extraction and lead to a challenging prosthetic rehabilitation due to severely damaged abutment teeth. However, the current knowledge on MIR remains fragmental and based on a limited number of case reports.

A novel removable appliance for canine retraction: a case report

This case report outlines the use of a modified Leighton's retractor as a method for canine retraction in a patient with severe hypodontia, a history of aggressive periodontitis with tooth loss and idiopathic root resorption affecting multiple teeth. Treatment involved an upper removable appliance in combination with a lower sectional fixed appliance with the aim of improving aesthetics and function for the patient, whilst balancing the need to minimise treatment duration and modify treatment mechanics to reduce the orthodontic risks.

Orthodontic root resorption

External apical root resorption (EARR) is one of the most frequently reported iatrogenic side effects of orthodontic movement. Nevertheless, no robust and unequivocal scientific evidence is yet available in the literature regarding the clinical and biological factors that trigger EARR. The purpose of the present position paper is to provide clinicians, residents, and investigators a summary of our current understanding about root resorption caused by orthodontic tooth movement, based on up-to-date available scientific evidence. Morphological, structural, biomechanical, and biological differences account for predisposing the apical third to EARR compared to other root surfaces during orthodontic treatment. In addition, a relevant number of patient and treatment-related factors increase risk of EARR. The main patient-related factors are reviewed and discussed: genetic factors, tooth anatomy, demographic factors, malocclusion factors, previous endodontic treatment, medical history, short root anomaly. Similarly, the influence of treatment-related factors are analyzed with regard to the effect of: biomechanical factors, type of orthodontic appliance, adjunctive therapies to accelerate tooth movement, early treatment, maxillary expansion, teeth extractions, the duration of treatment and the amount of apical displacement. Clinical management of EARR from pre-treatment records to the monitoring strategy as well as recommendations for the post orthodontic-treatment period are presented as a guide for the clinician. Despite years of studies, we still do not fully understand EARR, but the future is promising. True three-dimensional imaging with higher resolution and low radiation, and predictive tools towards an earlier detection without radiographs, will mark future developments in the field of EARR in orthodontics.

[Dental root resorption etiology, diagnosis and treatment]

The process of resorption of hard tooth tissues is associated with the activity of osteoclasts. However, the initiation of resorption can be caused by many factors acting separately or simultaneously. The paper presents the characteristics of pathological tooth resorption. The main etiological factors, pathogenesis, clinical manifestations, as well as treatment of various forms of tooth resorption are described.

Clinical Management of Two Root Resorption Cases in Endodontic Practice

Root resorption is a pathological process involving loss of hard dental tissues. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. Wide open apical foramen is more difficult to manage and the root canal may often overfill. In this report we present two cases of root resorption and describe means for its clinical management. We conclude that useful measure of a success or failure in managing root resorption is the persistence of the resorption process. It is a clear sign of an active ongoing inflammatory process and shows the clinical need for retreatment.

Multiple idiopathic external apical root resorption: A rare case report

Multiple idiopathic external apical root resorption (MIEARR) is a relatively rare condition affecting multiple teeth in a dentition. As the condition is nonsymptomatic, a case is usually detected as an incidental radiographic finding. However, it may cause pain and mobility in severe cases. It is sometimes self-limiting or sometimes may progress to tooth loss. This paper presents a case of external apical root resorption involving multiple teeth in which etiology was not identified, so idiopathic root resorption was considered as a diagnosis of exclusion.