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Spielman R, Ameh G, Brandes I, Berkowitz L, Elson N, Blum IR. Challenges in differential diagnosis and treatment of cervical root resorption vs. root caries. Prim Dent J 2024; 13:65-70. [PMID: 38888079 DOI: 10.1177/20501684241256468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
External cervical root resorption may be occasionally mistaken for root caries and vice versa. Radiographical and clinical differential diagnoses of cervical root resorption and root caries are essential for correct treatment planning and a successful treatment outcome. This article reviews the contemporary literature and summarises the prevailing professional consensus pertaining to external cervical root resorption. Clinical diagnostics which help distinguish cervical root resorption from root caries are outlined and treatment approaches of external cervical root resorption are discussed.
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Affiliation(s)
- Robert Spielman
- Robert Spielman Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Governor Ameh Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Irene Brandes DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Leonard Berkowitz DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Natalia Elson DDS, FWLI Clinical Assistant Professor & Group Practice Director, Department of General Dentistry & Comprehensive Care, New York University College of Dentistry, New York, USA; Senior Mentor, The Kells Society
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law)
- Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Governor Ameh
- Robert Spielman Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Governor Ameh Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Irene Brandes DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Leonard Berkowitz DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Natalia Elson DDS, FWLI Clinical Assistant Professor & Group Practice Director, Department of General Dentistry & Comprehensive Care, New York University College of Dentistry, New York, USA; Senior Mentor, The Kells Society
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law)
- Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Irene Brandes
- Robert Spielman Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Governor Ameh Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Irene Brandes DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Leonard Berkowitz DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Natalia Elson DDS, FWLI Clinical Assistant Professor & Group Practice Director, Department of General Dentistry & Comprehensive Care, New York University College of Dentistry, New York, USA; Senior Mentor, The Kells Society
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law)
- Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Leonard Berkowitz
- Robert Spielman Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Governor Ameh Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Irene Brandes DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Leonard Berkowitz DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Natalia Elson DDS, FWLI Clinical Assistant Professor & Group Practice Director, Department of General Dentistry & Comprehensive Care, New York University College of Dentistry, New York, USA; Senior Mentor, The Kells Society
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law)
- Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Natalia Elson
- Robert Spielman Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Governor Ameh Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Irene Brandes DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Leonard Berkowitz DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Natalia Elson DDS, FWLI Clinical Assistant Professor & Group Practice Director, Department of General Dentistry & Comprehensive Care, New York University College of Dentistry, New York, USA; Senior Mentor, The Kells Society
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law)
- Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Igor R Blum
- Robert Spielman Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Governor Ameh Undergraduate dental student, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Irene Brandes DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Leonard Berkowitz DDS Clinical Assistant Professor & Assistant Clinical Director, Department of General Dentistry and Comprehensive Care, New York University College of Dentistry, New York, USA
- Natalia Elson DDS, FWLI Clinical Assistant Professor & Group Practice Director, Department of General Dentistry & Comprehensive Care, New York University College of Dentistry, New York, USA; Senior Mentor, The Kells Society
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law)
- Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Khosravifard N, Vadiati Saberi B, Khosravifard A, Hendi A, Shadi K, Mihandoust S, Yousefi Z, Mortezaei T, Ghaffari ME. Introducing a new auto edge detection technique capable of revealing cervical root resorption in CBCT scans with pronounced metallic artifacts. Sci Rep 2024; 14:4245. [PMID: 38379025 PMCID: PMC10879123 DOI: 10.1038/s41598-024-54974-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/19/2024] [Indexed: 02/22/2024] Open
Abstract
Cervical resorption is a serious threat to the longevity of the teeth. In this study, the Canny edge-detection algorithm was applied on CBCT images to compare the accuracy of original and Canny views for diagnosing cervical resorption in endodontically treated teeth. Intracanal metallic posts were inserted in 60 extracted teeth being randomly divided into three groups: control, 0.5 mm, and 1 mm cervical resorption. CBCT scans of the teeth were presented to three observers in both original and Canny formats with the accuracy being determined by receiver operating characteristic (ROC) analysis. The DeLong test was used for paired comparisons with the significance level set at 0.05. The highest accuracy belonged to Canny images in 1 mm resorption, followed by Canny images in 0.5 mm resorption, original images in 1 mm resorption, and original images in 0.5 mm resorption, respectively. The Canny images were significantly more accurate in the diagnosis of 0.5 mm (p < 0.001) and 1 mm (p = 0.009) resorption. Application of the Canny edge-detection algorithm could be suggested as a new technique for facilitating the diagnosis of cervical resorption in teeth that are negatively affected by metallic artifacts.
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Affiliation(s)
- Negar Khosravifard
- Department of Oral and Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.
| | - Bardia Vadiati Saberi
- Department of Periodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Khosravifard
- Department of Mechanical Engineering, Shiraz University, Shiraz, Iran
| | - Amirreza Hendi
- Department of Dental Prosthesis, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Kimia Shadi
- Department of Oral and Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Sanaz Mihandoust
- Department of Oral and Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Yousefi
- Department of Oral and Maxillofacial Radiology, Dental Caries Prevention Research Center, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Tahereh Mortezaei
- Department of Oral and Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Huang J, Walsh RM, Witherspoon DE, Khalighinejad N, Tam EC, Jalali P, He J. The prevalence, characteristics, and risk factors of external cervical resorption: a retrospective practice-based study. Clin Oral Investig 2023; 27:5595-5604. [PMID: 37493728 DOI: 10.1007/s00784-023-05180-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVES External cervical root resorption (ECR) is a poorly understood and aggressive form of resorption. The purpose of this study was to examine the prevalence, characteristics, and risk factors associated with the occurrence of ECR in patients seeking endodontic care from private practice settings. MATERIALS AND METHODS Records of 343 patients with 390 teeth diagnosed with ECR were identified from 3 private endodontic practices from 2008 to 2022. The patients' demographic information, systemic conditions, and dental history were recorded. The characteristics of the cases including Heithersay classification, pulpal and periapical status, and their management were documented. The association between case severity and potential predisposing factors was examined using chi-square analysis. RESULTS The overall prevalence of ECR among patients seeking endodontic care was low (< 1%). However, there was a greater than twofold increase in the pooled prevalence from 2016 to 2021 (0.99%) compared to the data from 2010 to 2015 (0.46%). The most commonly affected teeth were anterior teeth (48.7%). Class II (30.0%) and class III (45.4%) defects were the most often identified. Patients with a history of trauma or orthodontic treatment were significantly more likely to be diagnosed with severe cervical resorption (class III or IV) (p < 0.05). CONCLUSIONS There has been an increase in the prevalence of ECR in patients seeking endodontic care. A history of orthodontic treatment and traumatic dental mechanical injuries may predict the severity of resorption. CLINICAL RELEVANCE The upward trend in the occurrence of ECR warrants close monitoring of the patients at high risk of developing the condition to facilitate early detection and management.
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Affiliation(s)
- Jenny Huang
- Department of Endodontics, Texas A&M University College of Dentistry, 3302 Gaston Ave., Dallas, TX, 75246, USA
| | - Ryan M Walsh
- Department of Endodontics, Texas A&M University College of Dentistry, 3302 Gaston Ave., Dallas, TX, 75246, USA
| | | | | | - Esther C Tam
- Department of Endodontics, Texas A&M University College of Dentistry, 3302 Gaston Ave., Dallas, TX, 75246, USA
| | - Poorya Jalali
- Department of Endodontics, Texas A&M University College of Dentistry, 3302 Gaston Ave., Dallas, TX, 75246, USA
| | - Jianing He
- Department of Endodontics, Texas A&M University College of Dentistry, 3302 Gaston Ave., Dallas, TX, 75246, USA.
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Okamoto M, Asahi Y, Duncan HF, Kuriki N, Takahashi Y, Hayashi M. Repair of an Extensive External Cervical Resorption Lesion Using Intentional Replantation with Crown Rotation. Case Rep Dent 2023; 2023:2103999. [PMID: 37441169 PMCID: PMC10335757 DOI: 10.1155/2023/2103999] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/01/2023] [Accepted: 06/17/2023] [Indexed: 07/15/2023] Open
Abstract
Treatment of large external cervical resorption (ECR) lesions may be compromised, rendering the tooth unrestorable. Intentional replantation is a potential treatment option depending on the site and extent of ECR. We present a case of a large ECR successfully managed with intentional replantation with rotation of the tooth. The female patient consulted the hospital clinic, with an extensive palatal ECR on the maxillary lateral incisor. Routine planar radiographs and cone-beam computed tomography demonstrated a larger palatal than the ECR lesion (Heithersay Class III and Patel's Class 2Bp) not amenable to nonsurgical treatment. Intentional replantation after short-term extrusion was planned. The defect was restored, then a palatal ferrule was achieved by rotating the tooth by 180°. At the 18-month follow-up, the periradicular and periodontal tissues remained healthy, and no other symptoms were reported. In conclusion, this successful video-illustrated clinical case highlights the benefits of intentional replantation in saving teeth with advanced ECR.
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Affiliation(s)
- Motoki Okamoto
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Yoko Asahi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Henry Fergus Duncan
- Division of Restorative Dentistry and Periodontology, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - Nanako Kuriki
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yusuke Takahashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan
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