Root Resorption

Summary

A correct diagnosis and an understanding of the underlying aetiology and processes involved in root resorption are essential for both effective management and appropriate treatment strategies. Tooth resorption can be broadly classified according to physiological or pathological processes as either internal or external. Resorption may be further categorized as due to either trauma, infection or hyperplastic invasive causes. The stimulus for internal resorption and external peri-radicular inflammatory resorption is intra-pulpal infection. Non-surgical root canal treatment will aim to eliminate intra-pulpal bacteria and arrest the resorptive process. Root resorption related to pressure such as orthodontic tooth movement, impacted teeth or tumours can be arrested by removal of the pressure stimulus. In external cervical root resorption infection originates from the periodontal sulcus, which provides the stimulus for continued tooth resorption. Removal of the granulation tissue and adequate sealing are prerequisites for repair. External replacement resorption is a direct consequence of irreversible periodontal ligament cell damage often seen in severe tooth trauma or non-physiological extra-oral storage of an avulsed tooth. Ankylosis and replacement resorption will ensue with normal remodelling of the surrounding bone and tooth structure resulting in the eventual demise.