Brief Review and Case Report Regarding Internal Resorption

Resorption is considered to such a condition which is associated with physiologic and pathologic process which results in the loss of dentin, bone and cementum. Its etiology initiates from various injuries to the tooth which may include thermal, mechanical and chemical injuries.

Different Types of Root Resorption

Presently there exist two different types of root resorption which include the following:

• External resorption – In case of external root resorption, the same gets initiated in the periodontium and initially affects the external surfaces of tooth. It can be further classified as surface, inflammatory, replacement or by cervical, lateral and apical location.
• Internal resorption – In case of internal root resorption, the inflammatory process is initiated within the pulp space with loss of dentin along with possible invasion of cementum.

Classification Associated with Internal Resorption Pathology

The pathology associated with internal resorption is caused due to transformation of normal pulp tissue into granulomatous tissues along with giant cells, known for resorbing dentin. The main classifications associated with the same can be specified as under:

• Inflammatory resorption – In an inflammatory resorption, the resorptive process in case of intra-radicular dentin progresses without adjunctive deposition of hard tissues adjacent to resorptive sites. The phenomenon is associated with presence of granulation tissues and easily identifiable with routine radiographs.
• Replacement resorption - In case of replacement resorption, the resorptive activity leads to the building of several defects in the dentin which is adjacent to the root canal along with concomitant deposition of bone like tissue. This results in an irregular enlargement of pulp space with partial or full obliterated area of the pulp chamber.

Major Contributing Factors in Internal Root Absorption

Recent studies have revealed the fact that trauma and pulpal infection are the two major contributory factors in the initiation of internal root resorption. It is typically detected clinically via routine radiographs. This is mainly observe in all areas of the root canal but is most commonly discovered in the cervical region of tooth. In a recent study conducted regarding the diagnosis of IRR, 43% of the patients hold trauma as common etiological factor following carious lesions at 25%.

Proper observation of defined outline of the pulp chamber is one of the key ways to diagnose internal resorption. The presence of pulp chamber outline is within the lesion, it refers to internal resorption. If the same is recognizable within radiolucent halo then it refers to external root resorption.

CBCT – Permits Accurate and Complete Diagnosis

As the usage of CBCT allows highly accurate and complete diagnosis of IRR, it is highly recommended in early presentations of potential resorption. As per Wimpole street dentist, though IRR is usually asymptotic, pain and discomfort can be considered to be the chief complaint in case of exposure of granulation tissue to oral fluids.

The pink shade is highly related to the vascular connective tissue which is adjacent to the resorbing cells. When the pulp becomes necrotic, it turns out to be grey. Teeth with IRR typically respond normally to the pulpal as well as periapical tests until significant growth of the size of lesion. It finally turns into perforation!

Rendering of Treatment and Prognosis

After necrosis of the pulpal tissue, the typical symptoms of an abscessing tooth get reflected. As vital pulp tissue is required for IRR, in case of complete pulpal necrosis, the growth of resorption ceases as resorbing cells are cut off from nutriments and blood supply. After getting diagnosed by dentist in W1, treatment considerations and prognosis get rendered.

Initiation of root canal therapy is highly recommended in case removal of vital tissue ceases progression of lesion. Still, the prognosis of long term form and function of the tooth is dependent on the size of the lesion.  Dentists are still on their own way to opt for further research studies regarding the same!

Reflection by Radiographs

Radiograph reveals significant bone loss around tooth in addition to the focalized loss of internal tooth structure in the apical one-third of the root in case of a loose front tooth. Sometimes perforation is also observed. Clinical exam revealed lack of recession probing depths of 8+ mm with class III mobility. Frequent dental visits after placing of crowns in the anterior area also results into such complicated issues!

Different forms of diagnosis of both internal and external resorption exist. Though earlier radiographs may aid differently in a more accurate and definitive diagnosis, internal resorption was due to the focal point of radio-lucency within the pulp chamber area. Due to extent of the associated defect and advanced bone loss along with periodontal disease, removal of tooth is recommended.

Assessing of Restoration Options – Also Recommended

Also assessing of other restoration options is also sometimes recommended. Upon removal of tooth, little root structure remains as it comes out in multitude of pieces. Internal root resorption is observed by Wimpole street dentist on a daily basis which is rare than external resorption. Root problems are generally neglected, but needs due extra attention.

The rendered treatment becomes highly favorable with early detection especially by the use of technology and CBCT scans, proper diagnosis and management. A wide number of resources are available which have been known to offer significant aid in the diagnosis and proper treatment of such lesions. This will enable proper maintenance of oral health hence preventing further spread of infections.

Read More

How Root Resorption Can Be Overcome

Many people around the world take the teeth surgery options. However, when it comes to the after effects of the surgeries, it is seen that various side effects take place sometimes. It is therefore important for the individuals to know the different aspects of surgery and the results as well as what are the nature of the effects that they may cause. The experts mostly do the surgeries and therefore the chances of side effects are quite nominal. In spite of that, some common symptoms may arise.

Physiologically root resorption is an entirely normal procedure, which happens with the timely loss of deciduous teeth. Root resorption has been contrasted with the scar that is the outcome of surgery. It might be characterized as the loss of apical root tissue; however, this in a few ways overly simplifies a complex multi factorial phenomenon. Amid tooth development (orthodontic or generally), powers are transmitted through the tooth to the periodontal ligament.

What are the different kinds of Root Resorptions:

Orthodontists are principally keen on External Root Resorption, which is a type of surface resorption. External Resorption alludes to the loss of apical root material only, different types of resorption can be watched i.e. Lateral (cervical) resorption on the buccal surface of molar roots amid quick maxillary extension treatment.

Internal Root Resorption is another form, which is supposedly caused by trauma, heat or other orthodontic issues. The tooth becoming loose is the main reason for this kind of Root resorption.

What is the Treatment for Root Resorption?

Smaller scale CT studies have recognized tiny zones of EARR of 0.1mm top to bottom in 90% of non-orthodontically treated permanent teeth. Small resorption lacunae particularly on the lateral parts of roots are thought to be harmless and a normal discovering reflecting the on-going balance in the middle of resorption and testimony.

There can be two ways to deal with this tooth resorption process. The first is to wait. In many cases, it happens that the resorption process ends a few weeks after surgery. Therefore, the patient has to be patient enough. Then if the tooth starts to loose then it is better to consult a dentist. He is the one who will understand if the tooth has to be uprooted or if it has to be supported until it gets back its support. The Wimpole Street Dentist is the best options for these treatments.

The finding of External Root Resorption is a typical sequel to orthodontic treatment. As being what is indicated, it should be a piece of the educated assent process. Fortunately, it is uncommon that root resorption is ever sufficiently broad to bring on any detrimental impact for the patient. In the greater part of cases, root resorption will keep on being a finding that only the scientist or occasionally the orthodontist will see on post treatment radiographs.

Read More

Non Vital Bleaching Technique: Helps to Improve Your Teeth

There are certain steps that one has to take in order to go through proper non vital bleaching process. At the same time it is better to note that specific dental processes are there as well.

Below are the steps:

1. Make the tooth restricted to a certain portion. The utilization of elastic dam segregation, interproximal wedges and ligatures are emphatically suggested.
2. Secure oral mucosa is a defensive cream, for example, oil jam must be connected to the encompassing oral mucosa to forestall compound blazes by the peroxides.
3. Dodge corrosive carving has not ended up being valuable and the utilization of harsh chemicals in the pulp chamber is undesirable, as periodontal ligament bothering may come about.
4. Review patients occasionally. Blanched teeth ought to be oftentimes examined both clinically and radiographically. Root resorption might every so often be identified as right on time as 6 months in the wake of bleaching. Early discovery enhances the guess as remedial therapy may at present be connected.
5. Confirm satisfactory endodontic obturation. The root canal filling must be thick and asyptomatic (demonstrating no proof of disease). The root canal ought to be finished no less than a month prior to bleaching. Expel excess filling material from the pulp chamber to 1-1.5mm underneath the gingival peak yet instantly of the periodontal ligament. Place a seal (e.g.zinc phosphate concrete/ Cavit/glass ionomer) over the gutta percha to disconnect it from the pulp chamber. The Root resorption process should go like this only. Place the bond high lingually and horizontally against the inside dividers to forestall leakage into the PDL (periodontal ligament). The nature of root canal obturation ought to dependably be evaluated clinically and radiographically preceding bleaching. Sufficient obturation guarantees a superior general anticipation of the treated tooth. It gives an extra hindrance against harm by peroxides to the periodontal ligament and periapical tissues.

Treatments Available:

There is, nonetheless, one possible arrangement to non vital bleaching technique: a brightening procedure known as inner or non-vital bleaching can lighten a darkened portion. For this system, we would embed a bleaching mix (generally sodium perborate mixed with hydrogen peroxide) into the pulp chamber of the darkened tooth for a brief time of time.

The first step is to verify by x-rays that the root canal filling in the tooth is still in place and still has a decent seal. Then a little opening is made in the back of the tooth simply over the root canal filling, watered with water to evacuate any trash, and after that included an exceptional bond at the point where the root canal filling starts to seal it from any spillage of the bleaching arrangement into the root canal filling.

The Wimpole Street Dentist then embeds the bleaching arrangement into the void pulp chamber. This is secured with a cotton pellet, which is then fixed in with a makeshift filling. They rehash this application more than various days until they see an observable change in the tooth shading (typically after one to four visits). As of right now, they would evacuate any leftover arrangement and apply a lasting filling to seal the tooth.

This methodology can be performed rather than more extensive strategies, for example, finishes and crowns as a spread for the discolored tooth, or as an approach to lighten teeth before applying a polish or crown to help keep staining from indicating through. Either way, non-vital bleaching can help evacuate unattractive staining and restore liveliness to your grid.

Read More