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International Endodontic Journal Oct 2022Root resorption is the loss of dental hard tissue because of odontoclastic action. In permanent teeth, it is undesirable and pathological in nature. Root resorption may... (Review)
Review
Root resorption is the loss of dental hard tissue because of odontoclastic action. In permanent teeth, it is undesirable and pathological in nature. Root resorption may occur on the inner aspect of the root canal (internal root resorption) or on the outer aspect of the root (external root resorption). Regardless of its location, root resorption is irreversible, and may result in discomfort for the patient, requires management and/or, in some cases, results in the premature loss of the affected tooth. Root resorption is often challenging to accurately diagnose and manage. The aim of this narrative review is to present the relevant literature on the aetiology, pathogenesis, diagnosis and management, as well as discuss the future directions of diagnosis and management of root resorption.
Topics: Humans; Root Resorption; Root Canal Therapy; Dentition, Permanent
PubMed: 35229320
DOI: 10.1111/iej.13715 -
Science Progress 2022Tooth root resorption is multifactorial, leading to progressive destruction and eventual loss of tooth root dentin and cement. There are internal and external types of... (Review)
Review
Tooth root resorption is multifactorial, leading to progressive destruction and eventual loss of tooth root dentin and cement. There are internal and external types of root resorption, each having its variety. The etiology and pathogenesis of tooth root resorption are poorly understood, and the most significant etiological factors are trauma, pulpal infection, tooth bleaching, and orthodontic treatment. Tooth root resorption is primarily asymptomatic; thus, it is revealed accidentally by radiographic examination. Progressive clinical manifestations are pain, tooth discoloration, tooth mobility, and other conditions. Awareness of the causes and risk factors allowing tooth root resorption, and regular radiographic examination, in case of necessity, make it possible to reveal resorption at an early stage and to prevent its further development. Thus, the aim of this study is to present etiopathogenesis, a clinical course, and diagnostic peculiarities of internal and external types of tooth root resorption, enabling practicing dentists to timely diagnose root resorption and take appropriate measures to avoid further complications. Within the limitation of this review, even though the etiopathogenesis of tooth root resorption is yet not fully understood, it is suggested that the etiological factors fall into two groups (endogenic and exogenic) to enhance further understanding of the possible causes and mechanisms of root resorption and allow practitioners to monitor high-risk patients and make timely diagnoses. Moreover, radiographic examination and CBCT are indispensable for the diagnosis of root resorption.
Topics: Humans; Root Resorption; Tooth Discoloration; Tooth Root
PubMed: 35759366
DOI: 10.1177/00368504221109217 -
Dental Traumatology : Official... Aug 2022Tooth resorption is either a physiological or a pathological process resulting in loss of dentin and/or cementum. It may also be associated with bone loss. Currently... (Review)
Review
Tooth resorption is either a physiological or a pathological process resulting in loss of dentin and/or cementum. It may also be associated with bone loss. Currently there is no universal classification for the different types of tooth resorption. This lack of a universal classification leads to both confusion amongst practitioners and poor understanding of the resorptive processes occurring in teeth which can result in incorrect/inappropriate diagnoses and mis-management. When developing a classification of diseases and/or conditions that occur within the body, several criteria should be followed to ensure a useful classification. The classification should not only include pathological conditions but also physiological conditions. Since tooth resorption can be either pathological or physiological, a classification of tooth resorption should include both of these categories. Any classification of diseases should be possible to use clinically, meaningful, useful, clear and universal. It should enable easy storage, retrieval and analysis of health information for evidenced-based decision-making. It should also be possible to share and compare data and information between different institutions, settings and countries. A classification of tooth resorption should be developed by combining anatomical, physiological and pathological approaches. For some types of resorption, the aetiological approach should also be incorporated. A classification of tooth resorption that uses simple, relevant and appropriate terminology based on the nature and location of the resorptive process occurring in teeth is proposed. There are two broad categories of internal and external tooth resorption which are sub-divided into three types of internal tooth resorption (surface, inflammatory, replacement) and eight types of external tooth resorption (surface, inflammatory, replacement, invasive, pressure, orthodontic, physiological, idiopathic). The clinician's understanding, diagnosis and management of tooth resorption can be facilitated by using this simple classification which should ideally be used universally by the entire dental profession to ensure clarity and to avoid confusion.
Topics: Dental Cementum; Humans; Molar; Root Resorption; Tooth Resorption
PubMed: 35605161
DOI: 10.1111/edt.12762 -
Dental Traumatology : Official... Aug 2022In 1966, Andreasen and Hjørting-Hansen were the first to describe a relationship between tooth resorption and dental trauma. However, Andreasen's original... (Review)
Review
In 1966, Andreasen and Hjørting-Hansen were the first to describe a relationship between tooth resorption and dental trauma. However, Andreasen's original classification did not include other resorptive processes which have since been identified. Numerous articles have been published suggesting new terminology and definitions for tooth resorption. A uniform language with universally accepted terminology is crucial to eliminate the multiplicity of terms and definitions which only cause confusion within the profession. An electronic literature search was carried out in the PubMed database using the following keywords for articles published in English: "root resorption," "inflammatory root resorption," "replacement resorption," "cervical resorption," "trauma," "ankylosis," "surface resorption," and "internal resorption." The search also included textbooks and glossaries that may not have surfaced in the online search. This was done to identify articles related to tooth resorption and its etiology in dentistry. The aim of this review was to present the history that has led to the variety of terms and definitions for resorption. This review emphasizes the need for a clearer, simpler, and more comprehensive nomenclature for the various types of tooth resorption which are presented in Part 2 of this series.
Topics: Humans; Root Resorption; Tooth Ankylosis; Tooth Resorption
PubMed: 35559593
DOI: 10.1111/edt.12757 -
Journal of Dental Research Feb 2017External apical root resorption during orthodontic treatment implicates specific molecular pathways that orchestrate nonphysiologic cellular activation. To date, a... (Review)
Review
External apical root resorption during orthodontic treatment implicates specific molecular pathways that orchestrate nonphysiologic cellular activation. To date, a substantial number of in vitro and in vivo molecular, genomic, and proteomic studies have supplied data that provide new insights into root resorption. Recent mechanisms and developments reviewed here include the role of the cellular component-specifically, the balance of CD68, iNOS M1- and CD68, CD163 M2-like macrophages associated with root resorption and root surface repair processes linked to the expression of the M1-associated proinflammatory cytokine tumor necrosis factor, inducible nitric oxide synthase, the M1 activator interferon γ, the M2 activator interleukin 4, and M2-associated anti-inflammatory interleukin 10 and arginase I. Insights into the role of mesenchymal dental pulp cells in attenuating dentin resorption in homeostasis are also reviewed. Data on recently deciphered molecular pathways are reviewed at the level of (1) clastic cell adhesion in the external apical root resorption process and the specific role of α/β integrins, osteopontin, and related extracellular matrix proteins; (2) clastic cell fusion and activation by the RANKL/RANK/OPG and ATP-P2RX7-IL1 pathways; and (3) regulatory mechanisms of root resorption repair by cementum at the proteomic and transcriptomic levels.
Topics: Animals; Cytokines; Dental Cementum; Humans; Orthodontics, Corrective; Root Resorption; Signal Transduction
PubMed: 27811065
DOI: 10.1177/0022034516677539 -
International Journal of Oral Science Jun 2021Nowadays, orthodontic treatment has become increasingly popular. However, the biological mechanisms of orthodontic tooth movement (OTM) have not been fully elucidated.... (Review)
Review
Nowadays, orthodontic treatment has become increasingly popular. However, the biological mechanisms of orthodontic tooth movement (OTM) have not been fully elucidated. We were aiming to summarize the evidences regarding the mechanisms of OTM. Firstly, we introduced the research models as a basis for further discussion of mechanisms. Secondly, we proposed a new hypothesis regarding the primary roles of periodontal ligament cells (PDLCs) and osteocytes involved in OTM mechanisms and summarized the biomechanical and biological responses of the periodontium in OTM through four steps, basically in OTM temporal sequences, as follows: (1) Extracellular mechanobiology of periodontium: biological, mechanical, and material changes of acellular components in periodontium under orthodontic forces were introduced. (2) Cell strain: the sensing, transduction, and regulation of mechanical stimuli in PDLCs and osteocytes. (3) Cell activation and differentiation: the activation and differentiation mechanisms of osteoblast and osteoclast, the force-induced sterile inflammation, and the communication networks consisting of sensors and effectors. (4) Tissue remodeling: the remodeling of bone and periodontal ligament (PDL) in the compression side and tension side responding to mechanical stimuli and root resorption. Lastly, we talked about the clinical implications of the updated OTM mechanisms, regarding optimal orthodontic force (OOF), acceleration of OTM, and prevention of root resorption.
Topics: Humans; Osteoblasts; Osteoclasts; Periodontal Ligament; Periodontium; Root Resorption; Tooth Movement Techniques
PubMed: 34183652
DOI: 10.1038/s41368-021-00125-5 -
The Cochrane Database of Systematic... Nov 2015External root resorption is a pathological process, which tends to occur following a wide range of mechanical or chemical stimuli such as infection, pressure, trauma or... (Review)
Review
BACKGROUND
External root resorption is a pathological process, which tends to occur following a wide range of mechanical or chemical stimuli such as infection, pressure, trauma or orthodontic tooth movement. Although it is predominantly detected by radiography, in some cases root resorption may be identified by clinical symptoms such as pain, swelling and mobility of the tooth. Treatment alternatives are case-dependent and aim to address the cause of the resorption and aid the regeneration of the resorptive lesion.
OBJECTIVES
To evaluate the effectiveness of any interventions that can be used in the management of external root resorption in permanent teeth.
SEARCH METHODS
The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 14 October 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 9), MEDLINE via OVID (1946 to 14 October 2015) and EMBASE via OVID (1980 to 14 October 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials of permanent teeth with any type of external root resorption, which has been confirmed by clinical and radiological examination, comparing one type of intervention (root canal medications and canal filling, splinting or extraction of teeth or the surgical removal of any relevant pathology) with another, or with placebo or no treatment.
DATA COLLECTION AND ANALYSIS
Two review authors screened search records independently. Full papers were obtained for potentially relevant trials. If data had been extracted, the statistical guidelines set out in the Cochrane Handbook would have been followed.
MAIN RESULTS
No randomised controlled trials that met the inclusion criteria were identified. However, we identified one ongoing study that is potentially relevant to this review and will be assessed when it is published.
AUTHORS' CONCLUSIONS
We were unable to identify any reports of randomised controlled trials regarding the efficacy of different interventions for the management of external root resorption. In view of the lack of reliable evidence on this topic, clinicians must decide on the most appropriate means of managing this condition according to their clinical experience with regard to patient-related factors. There is a need for well designed and conducted clinical trials on this topic, which conform to the CONSORT statement (www.consort-statement.org/).
Topics: Dentition, Permanent; Humans; Root Resorption
PubMed: 26599212
DOI: 10.1002/14651858.CD008003.pub3 -
Schweizer Monatsschrift Fur Zahnmedizin... 2010Today, the bleaching of nonvital, discolored teeth is a low-risk routine treatment for improving esthetics. This review article focuses on the etiology of tooth... (Review)
Review
Today, the bleaching of nonvital, discolored teeth is a low-risk routine treatment for improving esthetics. This review article focuses on the etiology of tooth discolorations, different treatment techniques, and risks of bleaching procedures. Some tooth discolorations in endodontically treated teeth are caused by dental treatments. The three most popular techniques for nonvital tooth bleaching are the walking bleach technique, inside/outside bleaching, and in-office bleaching. The walking bleach technique is a relatively reliable, fairly simple technique for dentists and patients. Inside/outside bleaching can be used additionally when internal and external bleaching must be combined. In-office bleaching seems to be a short-term solution, the effects of which can largely be attributed to dehydration of the teeth. There are still some open questions concerning the bleaching agents. Improved safety seems desirable with regard to adding thiourea as a scavenger of radicals or newer materials such as sodium percarbonate. The thermocatalytic technique, insufficient cervical sealing, and high concentrations of bleaching agents should be avoided, as this can increase the risk of cervical root resorptions. Patients should be informed about the low predictability of bleaching success and the risk of recurrent discoloration. The risk of cervical root resorption should be discussed with the patient. There is a strong correlation between root resorption and dental trauma.
Topics: Humans; Recurrence; Root Resorption; Tooth Bleaching; Tooth Bleaching Agents; Tooth Discoloration; Tooth, Nonvital
PubMed: 20514558
DOI: No ID Found -
International Journal of Molecular... Feb 2021The aim of this paper is to provide a review on the role of inflammation in orthodontically induced inflammatory root resorption (OIIRR) and accelerating orthodontic... (Review)
Review
The aim of this paper is to provide a review on the role of inflammation in orthodontically induced inflammatory root resorption (OIIRR) and accelerating orthodontic tooth movement (AOTM) in orthodontic treatment. Orthodontic tooth movement (OTM) is stimulated by remodeling of the periodontal ligament (PDL) and alveolar bone. These remodeling activities and tooth displacement are involved in the occurrence of an inflammatory process in the periodontium, in response to orthodontic forces. Inflammatory mediators such as prostaglandins (PGs), interleukins (Ils; IL-1, -6, -17), the tumor necrosis factor (TNF)-α superfamily, and receptor activator of nuclear factor (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) are increased in the PDL during OTM. OIIRR is one of the accidental symptoms, and inflammatory mediators have been detected in resorbed roots, PDL, and alveolar bone exposed to heavy orthodontic force. Therefore, these inflammatory mediators are involved with the occurrence of OIIRR during orthodontic tooth movement. On the contrary, regional accelerating phenomenon (RAP) occurs after fractures and surgery such as osteotomies or bone grafting, and bone healing is accelerated by increasing osteoclasts and osteoblasts. Recently, tooth movement after surgical procedures such as corticotomy, corticision, piezocision, and micro-osteoperforation might be accelerated by RAP, which increases the bone metabolism. Therefore, inflammation may be involved in accelerated OTM (AOTM). The knowledge of inflammation during orthodontic treatment could be used in preventing OIIRR and AOTM.
Topics: Animals; Humans; Inflammation; Osteogenesis; Root Resorption; Tooth Movement Techniques
PubMed: 33673606
DOI: 10.3390/ijms22052388 -
Clinical Oral Investigations Sep 2009Root resorption of maxillary lateral incisors caused by erupting canines is well known and a relatively common phenomenon. However, much debate and conflicting evidence... (Review)
Review
Root resorption of maxillary lateral incisors caused by erupting canines is well known and a relatively common phenomenon. However, much debate and conflicting evidence exists with regard to the actual resorption trigger and potential etiological factors involved. Consequently, there are no obvious clinical clues concerning prevention and diagnosis as well as subsequent treatment decisions. The introduction of cone beam computer tomography has recently allowed drawing a new and much more documented light on the diagnostic and therapeutic strategies. However, no investigations have determined that this new information may result in another and better diagnostic approach and an improved treatment outcome. Therefore, the present review will attempt to summarize the existing evidence on two- and three-dimensional images and try to link the radiological observations to any further preventive, diagnostic, and/or therapeutic measures. Detection thresholds, accuracy, and reliability of impacted canine localization and neighboring root resorption risks will also be considered. This review demonstrates how adding a third-dimension to the radiographic information may notably alter the prevalence of root resorptions and descriptions of this prevalence. In any case, further investigation is needed to determine resorption detection thresholds in various two-dimensional and three-dimensional imaging techniques, as well as to determine therapeutic thresholds and criteria for strategic tooth extraction based on radiographic manifest and not manageable resorption lesions.
Topics: Cone-Beam Computed Tomography; Cuspid; Dental Sac; Humans; Imaging, Three-Dimensional; Incisor; Maxilla; Orthodontics, Corrective; Root Resorption; Tooth Eruption, Ectopic; Tooth, Impacted
PubMed: 19277728
DOI: 10.1007/s00784-009-0262-8