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PubMed1988

Dentin resorption mediated by odontoclasts in physiological root resorption of human deciduous teeth.

Extracted human deciduous teeth undergoing physiological root resorption were fixed with a mixture of formaldehyde and glutaraldehyde and processed for scanning (SEM) and analytical transmission electron microscopy, as well as acid trimetaphosphatase cytochemistry. The granulated tissues, which are rich in multinucleated odontoclasts and capillary vessels, formed various resorption lacunae on the resorbing dentin surfaces. SEM observations of dentin surfaces treated with sodium hypochlorite revealed two types of resorption lacunae: deep, round lacunae in which the peritubular matrix of dentinal tubules was strongly dissolved; and shallow, irregular lacunae with intact peritubular matrix. In trypsin-treated materials, the resorption surfaces were characterized by the presence of numerous collagen fibers in both the peritubular and intertubular matrices, suggesting demineralization of the surface dentin. Odontoclasts were characterized by the presence of abundant mitochondria, perinuclear stacks of Golgi membranes, various lysosomes, numerous endocytotic vacuoles, and a well-developed ruffled border against the resorption lacunae. Most endocytotic vacuoles were distributed in the cytoplasm between the ruffled border and the nuclei. In undemineralized ultrathin sections, the surface dentin of resorption lacunae consisted of collagen fibers and apatite crystals and had a lower packing density than those in unresorbed, deeper dentin. Many apatite crystals were demonstrated to be present in the extracellular channels of the ruffled border and in adjacent endocytotic vacuoles derived from it. Lysosomes located in the perinuclear cytoplasm of odontoclasts contained amorphous dense material and/or a small amount of crystals. An energy-dispersive x-ray microanalysis of apatite crystals in undemineralized sections indicated that the energy spectrum peaks of Ca and P detected from crystals in resorbing dentin were much lower than those in unresorbed dentin. Similarly, lower spectrum peaks of Ca and P were obtained from crystals found in the ruffled border and endocytotic vacuoles of odontoclasts. A slight trace Ca peak also was detected in the amorphous dense material in lysosomes of odontoclasts. The enzyme cytochemistry of lysosomal acid trimetaphosphatase indicated that odontoclasts had intense enzymatic activity in the Golgi membranes, endoplasmic reticulum cisternae, lysosomes, and endocytotic vacuoles. Dense reaction precipitates of enzymatic activity also were found along the dentin surfaces of resorption lacunae occupied by odontoclast ruffled borders.(ABSTRACT TRUNCATED AT 400 WORDS)

Acid Anhydride Hydrolases↗
PubMed1995

A scanning electron microscopic study of external root resorption in replanted dog teeth.

Root resorption after replantation of mature permanent dog incisors was examined by scanning electron microscopy. Three groups consisting of three extracted teeth each were kept in a saline solution for 5, 30, and 120 min before replantation. The first group was replanted with the pulp intact. The second and third groups were replanted after root canal filling by Calciobiotic Root Canal Sealer. After 90 days, the teeth were extracted and the apical root surfaces were examined. Severe inflammatory root resorption was observed in the first (intact pulp) group. For the root canal filled teeth, the degree of root resorption was observed to be much less in those kept in saline for 30 min than in those kept for 120 min.

Animals↗
PubMed2006

Inflammatory external root resorption following surgical treatment for intra-bony defects: a report of two cases involving Emdogain and a review of the literature.

BACKGROUND: Enamel matrix-derived proteins have been shown to regenerate periodontal tissues lost as a result of disease in humans. Emdogain, a commercial preparation of porcine enamel matrix derivative (EMD), has been shown to induce new cementum, periodontal ligament and bone formation in human periodontal defects. Although a number of studies have reported successful outcomes, local adverse effects have so far not been reported in the literature. This case report describes two examples of external inflammatory resorption following surgical root surface debridement and the use of Emdogain. TREATMENT: The treatment in both cases involved raising a full-thickness flap following completion of non-surgical therapy. The granulation tissue from the defect was removed and the root surfaces debrided. Emdogain was applied following the manufacturers' instructions and involved conditioning the root surfaces with Pref-Gel and applying the Emdogain to the defect. The flaps were sutured and the site reviewed regularly. Radiographs were taken before the treatment was undertaken and also at 6 months to assess the healing of the defect. RESULTS: External inflammatory root resorption was observed on the treated teeth 6-24 months after therapy. CONCLUSION: External inflammatory root resorption may be an unusual adverse event following Emdogain treatment.

Adult↗
PubMed1998

Directions of orthodontic tooth movements associated with external apical root resorption of the maxillary central incisor.

External apical root resorption is a multifactorial problem encountered in all disciplines of dentistry, but it is most commonly seen in cases treated orthodontically. Specific tooth movements that are most likely to exacerbate external apical root resorption are poorly understood. Purpose of the present investigation was twofold: (1) to quantify apical and incisal movements of the maxillary central incisor in the sagittal and vertical planes from cephalograms and (2) to use stepwise multivariate linear regression analyses to see which tooth movements and skeletodental relationships are most predictive of external apical root resorption. The sample consisted of 110 adolescents with similar pretreatment malocclusions (Class I crowded or bimaxillary protrusive) and treatment planned similarly (extraction of four first premolars) by experienced private practitioners. Each of three practitioners used a different orthodontic appliance; the sample was divided proportionately into cases treated with Tweed standard edgewise technique, Begg lightwire technique, and Roth-prescription straightwire technique. Lateral cephalograms were analyzed at the start, middle, and end of treatment. There was no statistical difference in average external apical root resorption between sexes or among techniques. Measures of tooth movement were highly predictive, explaining up to 90% of the variation in root resorption. Apical and incisal vertical movements and increase in incisor proclination were the strong predictors of external apical root resorption for each regression model. Incisor intrusion with increase in lingual root torque together were the strongest predictors of external apical root resorption. In contrast, distal bodily retraction, extrusion, or lingual crown tipping had no discernible effect.

Adolescent↗
PubMed2004

Incidence and severity of root resorption in orthodontically moved premolars in dogs.

OBJECTIVES: To study treatment-related factors for external root resorption during orthodontic tooth movement. DESIGN: An experimental animal study. SETTING AND SAMPLE POPULATION: Department of Orthodontics and Oral Biology, University Medical Centre Nijmegen, The Netherlands. Twenty-four young adult beagle dogs. EXPERIMENTAL VARIABLE: Mandibular premolars were bodily moved with continuous or intermittent controlled orthodontic forces of 10, 25, 50, 100, or 200 cN according to standardized protocols. At different points in time histomorphometry was performed to determine the severity of root resorption. OUTCOME MEASURE: Prevalence of root resorptions, defined as microscopically visible resorption lacunae in the dentin. Severity of resorption was defined by the length, relative length, depth, and surface area of each resorption area. RESULTS: The incidence of root resorption increased with the duration of force application. After 14-17 weeks of force application root resorption was found at 94% of the root surfaces at pressure sides. The effect of force magnitude on the severity of root resorption was not statistically significant. The severity of root resorption was highly related to the force regimen. Continuous forces caused significantly more severe root resorption than intermittent forces. A strong correlation (0.60 < r < 0.68) was found between the amount of tooth movement and the severity of root resorption. CONCLUSIONS: Root resorption increases with the duration of force application. The more teeth are displaced, the more root resorption will occur. Intermittent forces cause less severe root resorption than continuous forces, and force magnitude is probably not decisive for root resorption.

Analysis of Variance↗
PubMed1993

Root resorption after orthodontic treatment: Part 2. Literature review.

All permanent teeth may show microscopic amounts of root resorption that are clinically insignificant and radiographically undetected. Root resorption of permanent teeth is a probable consequence of orthodontic treatment and active tooth movement. The incidence of reported root resorption during orthodontic treatment varies widely among investigators. Usually, extensive resorption does not affect the functional capacity or the effective life of the tooth. Most studies agree that the root resorption process ceases once the active treatment is terminated. Root resorption of the deciduous dentition is a normal, essential, and physiologic process. Permanent teeth have the potential to clinically undergo significant external root resorption when affected by several stimuli. This resorptive potential varies in persons and between different teeth in the same person. This throws doubt on the role of systemic factors as a primary cause of root resorption during orthodontic treatment. Tooth structure, alveolar bone structure at various locations, and types of movement may explain these variations. The extent of treatment duration and mechanical factors definitely influence root resorption. In most root resorption studies, it is not possible to compare the results and conclusions because of their different methods. Further research in this field is necessary to advance the service of the specialty. The question of whether there is an optimal force to move teeth without resorption or whether root resorption may be predictable remain unanswered. This review indicates the unpredictability and widespread incidence of the root resorption phenomenon.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1976

Root resorption by ameloblastomas and cysts of the jaws.

Radiographs of 122 cases of a series of nonmalignant simple jaw cysts and ameloblastomas were examined and the frequency of resorption of adjacent tooth roots compared. The ameloblastomas proved to have a root resorptive potential far greater than the cystic lesions considered. Certain statistically significant differences were observed in the root resorption related to the cystic lesions. The dentigerous cyst showed a tendency to resorb roots (55%), whereas in this study no resorption was observed in primordial cysts. These differences may aid the clinician in the preoperative differential diagnosis. It is suggested that the capacity of the dentigerous cyst for root resorption may be the result of its origin from the dental follicle, which is associated with resorption of the roots of primary teeth during normal tooth succession.

Ameloblastoma↗
PubMed2006

Inhibition of orthodontically induced root resorption with echistatin, an RGD-containing peptide.

INTRODUCTION: Induced dental root resorption is a common side effect of orthodontic treatment. It is an unpredictable phenomenon, and its etiology is unknown. Odontoclasts responsible for the resorption of the dental tissues--ie, cementum and dentin--share many cytochemical and morphological characteristics with osteoclasts, which are responsible for bone resorption. The aim of this study was to explore cellular mechanisms that decrease induced root resorption in orthodontically treated teeth. METHODS: The effects of targeting the alphavbeta3 integrin receptor, expressed by odontoclasts, on induced root resorption surface areas and the number of root resorption lacunae were investigated by using an RGD-containing peptide, echistatin. The effect of echistatin on the number of clast cells in the periodontium was also examined. Tooth movement was achieved in 14 Sprague-Dawley rats by placing elastic bands between the right maxillary first and second molars for 24 hours. The animals were equally divided into 2 groups; the experimental animals received echistatin intravenously for 8 hours (0.8 microg/kg/min), and the controls received sterile water. The specimens obtained were processed for light microscopy. The surface area and the number of root resorption lacunae were measured histomorphometrically by using digital photomicrographs. Echistatin labeled with a fluorescent marker was used to confirm its presence in clast cells with fluorescent microscopy. Cytochemically, tartrate-resistant acid phosphatase was used to quantify mature and committed clast cells. Echistatin was localized in targeted cells in the periodontium. RESULTS: Echistatin significantly decreased root resorption surface areas (P < .01) and reduced the number of root resorption lacunae (P < .01). There was no statistically significant difference in clast cell numbers. CONCLUSIONS: Targeting alphavbeta3 integrin receptor expressed by odontoclasts can be effective in reducing root resorption during tooth movement. Further studies are needed to elucidate the mechanism of this inhibition.

Amino Acid Sequence↗
PubMed2007

Physical properties of root cementum: Part 9. Effect of systemic fluoride intake on root resorption in rats.

INTRODUCTION: Orthodontically induced inflammatory root resorption is a common complication in orthodontic treatment. Fluoride has been reported to have a beneficial effect against root resorption in dental traumatology. The effect of fluoride on orthodontically induced inflammatory root resorption has not been investigated. This study was undertaken to investigate the effect of fluoride on the incidence of root resorption. METHODS: Thirty-two female 8-week-old Wistar rats were separated into 4 groups. Two groups (6 rats per group) were controls; they did not undergo orthodontic tooth movement. The other 2 groups (10 rats per group) had orthodontic tooth movement consisting of activated 100-g closing nickel-titanium coils (NiTi 10-000-06, GAC International, Bohemia, NY) connecting the mandibular first molar to the incisors. Fluoridated water (100 ppm) was given ad libitum to 1 control and 1 experimental group. The other 2 groups received deionized water. After 2 weeks, the animals were killed, and the samples were harvested. Resorption craters were scanned with a Micro CT (SkyScan 1072, Aartselaar, Belgium). Software analysis of the scanned samples provided a volumetric measurement of the resorption craters on the mandibular molar cementum surface. RESULTS: Resorption sites were found in the control samples, especially on the distal surfaces; this could be attributed to normal physiological tooth drift. Resorption sites were significantly (P <.05) increased in the groups receiving orthodontic tooth movement. CONCLUSIONS: Fluoride reduces the size of resorption craters, but the effect is variable and not statistically significant (P >.05).

Administration, Oral↗
PubMed1996

Therapeutic delivery of calcitonin to inhibit external inflammatory root resorption. I. Diffusion kinetics of calcitonin through the dental root.

Insertion of calcitonin into root canals of monkey teeth has been shown to inhibit external inflammatory root resorption and suppress inflammation. Regulation of this therapeutic event depends upon the rate of arrival (diffusion) of the hormone at sites of resorptive activity. In the present study, the diffusion characteristics of calcitonin through the dental root in an extracted human-tooth model are described, and the role of cementum in the diffusion process is also addressed. Root-canals were endodontically prepared to form a reservoir for [125I]-calcitonin, and macerated to remove organic material from dentinal tubules. In teeth with intact cementum, an initial period of delay (4-5 h) prior to the detection of calcitonin at the external tooth-root surface was followed by a rapid release of the calcitonin during the first 10.5 h (rate peaks at 6 h). Slower, sustained releases of calcitonin through intact cementum were measured for the following 9 days. Removal of cementum, to expose "smear-free" dentine, resulted in an earlier efflux of calcitonin (2 h) at external tooth surfaces and increased amounts of calcitonin release over 9 days. Biphasic delivery of calcitonin by such internal diffusion mechanisms suggests that loss of cementum will enhance therapeutic availability, while prolonged delivery to intact external dental-root surfaces following early intra-canal placement may also be useful for the therapeutic prevention of external inflammatory root resorption.

Administration, Topical↗
PubMed1999

External apical root resorption of posterior teeth in asthmatics after orthodontic treatment.

External apical root resorption is an undesirable sequela of orthodontic treatment, resulting in loss of tooth structure from the root apex. It has been proposed that systemic factors, such as the inflammatory mediators produced in asthma, may enter the periodontal ligament and act synergistically to enhance root resorption. The aim of this study was to determine if asthmatic patients exhibited a higher incidence or severity of external apical root resorption compared with healthy (no medical conditions) patients after fixed orthodontic treatment. Records were obtained from patients treated with fixed appliances; 99 were healthy and 44 had asthma. Using OPGs (panoral films), posterior external apical root resorption was measured on all first and second premolars, mesiobuccal and distobuccal roots of the upper first molars, and mesial and distal roots of the lower first molars, giving 4 measurements per quadrant. A 4-grade ordinal scale was used to determine the degree of external apical root resorption. Combined tooth analysis (adjusted for treatment time, appliance, and extractions) showed that asthmatics had significantly more external apical root resorption of posterior teeth after treatment compared with the healthy group (P =.0194). Tooth-by-tooth analysis (adjusted for treatment time, appliance, extractions, headgear, overbite, overjet, sex, and age at start of treatment) found the upper first molars were most susceptible to external apical root resorption. Although the incidence of external apical root resorption was elevated in the asthma group, both asthmatics and healthy patients exhibited similar amounts of grade 2 (moderate) and grade 3 (severe) resorption.

Adult↗
PubMed2003

[A factors study of root resorption after orthodontic treatment].

OBJECTIVE: To investigate the factors relating to root resorption after orthodontic treatment. METHODS: 96 cases treated with fixed appliances were selected. The panoramic radiographs before and after treatment were examined. The relationship between root resorption after treatment (RRAT) and the variables including sex, age, extraction or nonextraction approach, tooth location, treatment duration and the root resorption before treatment (RRBT) were analyzed by multiple variance analysis and stepwise multivariate linear regression analyses. RESULTS: (1) There were statistically significant differences in root resorption in relation to gender (estimate of RRAT for female: 0.41, that for male: 0.34), extraction (estimate of RRAT for the extraction group: 0.43, that for non-extraction: 0.31), anterior or posterior teeth (estimate of RRAT for the anterior teeth: 0.59, that for the posterior teeth: 0.12). (2) The estimate of RRAT for the upper teeth was 0.40, and that for the lower teeth was 0.37. There were no statistically significant differences. (3) Using multiple regression analysis, age, duration and RRBT were associated with RRAT (R = 0.59, R(2) = 0.35). CONCLUSIONS: (1) Factors including gender, extraction or not and anterior or posterior teeth have influences on the RRAT. More root resorption was found in female or extraction cases. Anterior teeth were more susceptible to root resorption relative to posterior teeth. (2) Age, treatment duration and RRBT can explain approximately 35% of the RRAT. Root resorption aggregated when it was present before treatment. The age and treatment duration were lightly related to the root resorption.

Adolescent↗
PubMedDate not supplied

Idiopathic external root resorption associated to hypercalciuria.

Although external root resorption (ERR) is a physiological process in deciduous dentition, it is very infrequent in permanent dentition - where the phenomenon is related to the existence of inadequate occlusal forces, periodontal pathology and microtraumatisms, etc. However, in many cases root resorption cannot be attributed to any concrete cause; such cases are defined as idiopathic external root resorption (IERR). Epidemiological studies have found that the underlying cause can only be established in 5% of all ERR. The present study describes three cases of IERR with different degrees of involvement and associated to mild calciuria and a history of nephrolithiasis. Hypercalciuria with normal blood calcium levels is usually idiopathic and exhibits a familial trait, with a prevalence of 20-40 cases per 1,000 individuals in adults. A form of hypercalciuria associated to nephrolithiasis with a mutation of the CLCN5 gene has been identified, involving low molecular weight proteinuria - though this mutation has not been uniformly demonstrated in most cases of idiopathic hypercalciuria. The peculiarity of the cases described in the present study is attributable to the coexistence of IERR with normocalcemic hypercalciuria and nephrolithiasis - thus pointing to the need for in-depth evaluation of the possible association of these three clinical situations.

Adolescent↗
PubMed2000

A radiographic comparison of apical root resorption after orthodontic treatment with 3 different fixed appliance techniques.

Apical root resorption is an undesirable, but frequent side effect of orthodontic treatment, and therefore improvements in orthodontic techniques and materials are in constant development to decrease it. One of the most recently developed orthodontic techniques is the Bioefficient Therapy that uses contemporary orthodontic materials. Therefore, the primary objective of this study was to compare the amount of root resorption after orthodontic treatment between the simplified standard edgewise technique (group 1), the edgewise straight wire system (group 2), and the Bioefficient Therapy (group 3). It was also the purpose of this investigation to evaluate the amount of root resorption in the whole sample studied and the prevalence of root resorption in the upper and lower incisors. Thus, periapical radiographs were obtained with the long cone paralleling technique for the upper and lower incisors from 30 patients for each group. Root resorption was ranked by scores by 2 examiners who had an excellent intra and interexaminer calibration by Kendall concordance coefficient. Results of the Kruskal-Wallis test demonstrated that group 3 (Bioefficient Therapy) presented less root resorption than the others. It was speculated that the factors responsible for the lesser resorption in this technique were the use of heat-activated and superelastic wires with the bracket design in this technique as well as the use of a smaller rectangular stainless steel wire (0.018 x 0.025 inch) in a 0.022 x 0.028 inch slot during incisor retraction and the finishing stages, as compared to the other techniques. Considering the whole sample, there was no root resorption in 2.25% of the analyzed teeth. There was only a slight resorption in 42.56%, a moderate resorption in 53.37%, an accentuated resorption in 1.40% and an extreme root resorption in only 0.42% of the teeth. The prevalence of resorption for each incisor indicated, in decreasing order, a greater resorption for the upper centrals, followed by the upper laterals, lower centrals, and lastly the lower lateral incisors.

Adolescent↗
PubMed2003

Expression and role of RANKL in periodontal ligament cells during physiological root-resorption in human deciduous teeth.

Although important roles of receptor activator of NF-kappaB ligand (RANKL) and its receptor (RANK) have been established for osteoclastogenesis and bone resorption, their expression and roles during physiological root resorption remain uncertain. Physiological root resorption for shedding of human deciduous teeth is mediated by osteoclast-like cells (odontoclasts). In this study, we examined the expression of RANKL and osteoprotegerin (OPG), a decoy receptor that prevents RANKL from binding to RANK in human periodontal ligament (PDL) cells during physiological root resorption using immunocytochemistry and reverse transcriptase polymerase chain reaction. The effect of RANKL on root resorbing activity of odontoclasts was evaluated by measuring the size of dissolved area on calcium phosphate-coated coverslips. The PDL cells isolated from either non-resorbing deciduous teeth or permanent teeth abundantly expressed OPG, but not RANKL. In contrast, PDL cells derived from resorbing deciduous teeth dominantly expressed RANKL. Human odontoclasts derived from resorbing deciduous teeth expressed both RANKL and RANK. It was observed that RANKL increased odontoclast actin ring formation and resorbing activity in a dose-dependent manner. These results indicate that PDL cells during the root-resorbing state express RANKL but decrease OPG expression. Expression of RANKL likely participates in odontoclastogenesis and activates physiological root resorption.

Actins↗
PubMed2002

The effect of intracanal Ledermix on root resorption of delayed-replanted monkey teeth.

Progressive root resorption is one of the common sequelae in replanted teeth, which is detrimental to their long-term prognosis. Ledermix paste, with its composition of triamcinolone acetonide and demethylclortetracycline, has been shown to inhibit inflammation and the associated hard tissue resorption. This study evaluated the effect of immediate intracanal Ledermix on root resorption of delayed-replanted monkey teeth. A total of 36 roots were root canal treated. For the experimental group, intracanal Ledermix was placed prior to extraction and replantation after 1-h bench dry. The positive control group was root filled and replanted after 1 h while the negative control group was root filled and replanted immediately. The monkeys were sacrificed after 12 weeks. The H&E histological tissue specimens were prepared and evaluated using a method modified from that of Andreasen's morphometric analysis, as favorable or complete healing and unfavorable healing, comprising inflammatory root resorption and replacement resorption. The results were analyzed using Kruskal-Wallis and Mann-Whitney U-tests as well as Wilcoxon signed ranks test. The negative control group produced highly significant favorable healing and unfavorable healing as compared to the Ledermix group (P = 0.000). The Ledermix group only showed significantly higher occurrence of complete healing (35.46%) compared to the positive control group (16.58%) (P = 0.037) but there were no significant differences in the inflammatory root resorption and replacement resorption. Nevertheless, when the latter two unfavorable healing patterns were combined, there was a significantly lower overall unfavorable healing in the Ledermix group (64.54%) when compared to the positive control group (83.43%) (P = 0.037). This unfavorable healing outcome in the Ledermix group, however, was not significantly different from the favorable healing outcome with the same treatment modality (P = 0.110).

Animals↗
PubMed1995

Morphological characteristics of dentitions developing excessive root resorption during orthodontic treatment.

The present study focuses on orthodontically provoked, excessive root resorption. The purpose was to identify in these cases common morphological features in radiographic diagnostic material taken before treatment. The material was submitted by 35 Danish orthodontists. The goal was to improve the future orthodontic diagnostics of the dentition in order to prevent severe root resorption during treatment. The study indicates that: (1) there is a strong connection between various dental morphological characteristics, such as invagination, length of root, and root shapes, especially taurodontism, and the tendency to root resorption during orthodontic treatment; (2) there is a connection between anomalies in the dentition, particularly ectopia and agenesis, and the tendency to root resorption during orthodontic treatment; (3) there seems to be a connection between the pattern of resorption in the primary dentition and the tendency to root resorption in the permanent dentition following orthodontic treatment; (4) girls are more susceptible to root resorption during orthodontic treatment than boys; (5) one ought to be on the lookout for connections between condylar changes, root resorptions, and anterior open bites in connection with orthodontic treatment. The observation regarding root resorption in dentitions in which invaginations and taurodontic root shapes occur has not previously been reported. Also, the findings of deviant resorption patterns in both the primary and permanent dentitions in a considerable number of patients are new observations, which ought to be incorporated into orthodontic treatment planning.

Adolescent↗
PubMed2003

Root resorption--diagnosis, classification and treatment choices based on stimulation factors.

Etiology of different types of root resorption requires two phases: mechanical or chemical injury to the protective tissues and stimulation by infection or pressure. Injury can be similar in various types of root resorption. The selection of proper treatment is related to the stimulation factors. Intrapulpal infection is the stimulation factor in internal root resorption and external periradicular inflammatory root resorption. Adequate root canal treatment controls intrapulpal bacteria and arrests the resorption process. In cervical root resorption, infection originates from the periodontal sulcus and stimulates the pathological process. As adequate infection control in the sulcus is unlikely, removal of granulation tissue from the resorption lacuna and sealing are necessary for repair. Removal of the stimulation factor, i.e. pressure, is the treatment of choice in root resorption related to pressure during orthodontic treatment, or an impacted tooth or tumor. In ankylotic root resorption, there is no known stimulation factor; thus, no predictable treatment can be suggested. Therefore, various types of root resorptions can be classified according to the stimulation factors: pulpal infection resorption, periodontal infection resorption, orthodontic pressure resorption, impacted tooth or tumor pressure resorption, and ankylotic resorption.

Dental Pulp Diseases↗