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- KurzbeschreibungRoot resorption is a clinical condition whereby the mineralized tissues of the root are lost, mainly as an immunological response due to various factors. Root resorption has been a perplexing clinical condition for dental practitioners as it has a broad range of clinical manifestation with varied severity and also due to the associated diagnostic dilemma. Early detection is essential for successful management and outcome of root resorption. Root resorptions have several local and systemic predisposing factors. Hence, patients with a history of one or more predisposing factors should be monitored closely for initial signs of root resorption.
Cone beam computed tomography appears to be a promising diagnostic tool for confirming the presence, appreciating the true nature, and managing the internal and external root resorptions. In addition to the 2-D slices, 3-D reconstruction enables further assessment of the area of interest which enables the right treatment modality for the real pathology.
Thorough knowledge regarding the pathogenesis and various factors that can cause root resorption is essential for a predictive therapeutic management as is given in this overview. The book describes different types of root resorption, the etiopathogenesis and management strategies for each type of root resorption.
- AutorVineet R. V.
- VerlagAnchor Academic Publishing
- Seiten84 Seiten
- Gewicht140 g
- Leseprobe'Text sample:
Chapter ETIOLOGY AND PATHOGENESIS:
For internal root resorption to occur, the outermost protective odontoblast layer and the predentin of the canal wall must be damaged, resulting in exposure of the underlying mineralized dentin to odontoclasts. The precise injurious events necessary to bring about such damages have not been completely elucidated. Various etiologic factors have been proposed for the loss of predentin, including trauma, caries and periodontal infections, excessive heat generated during restorative procedures on vital teeth, calcium hydroxide procedures, vital root resections, anachoresis, orthodontic treatment, cracked teeth, or simply idiopathic dystrophic changes within normal pulps. In a study of 25 teeth with internal resorption, trauma was found to be the most common predisposing factor that was responsible for 45% of the cases examined. The suggested etiologies in the other cases were inflammation as a result of carious lesions (25%) and periodontal lesions (14%). The cause of the internal resorption in the remaining teeth was unknown. Other reports in the literature also support the view that trauma and pulpal inflammation/infection are the major contributory factors in the initiation of internal resorption.
Wedenberg and Lindskog reported that internal root resorption could be a transient or a progressive event. In an in vivo primate study, the root canals were accessed in 32 incisors with the predentin intentionally damaged. The access cavities in half of the teeth were sealed; the other half were left open to the oral cavity. The teeth were extracted at intervals of 1, 2, 6, and 10 weeks. The authors noted only a transient colonization of the damaged dentin by multinucleated clastic cells in the teeth that had been sealed (ie, transient internal root resorption). Those teeth were free from bacterial contamination, and no signs of active hard tissue resorption occurred. In the teeth that were left unsealed during the experimental period, there were signs of extensive bacterial contamination of pulpal tissue and dentinal tubules. Those teeth demonstrated extensive and prolonged colonization of the damaged dentin surface by clastic cells and signs of mineralized tissue resorption (progressive internal root resorption). Damage to the odontoblast layer and predentin of the canal wall is a prerequisite for the initiation of internal root resorption. However, the advancement of internal root resorption depends on bacterial stimulation of the clastic cells involved in hard tissue resorption. Without this stimulation, the resorption will be self-limiting
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