Why not to treat the tooth canal to solve external root resorptions? Here are the principles!

Abstract

This paper aims at exposing the foundations or reasons why, in cases of external tooth resorption, including those of orthodontic origin, one should not perform a root canal to treat it. That should be done only to teeth with contamination or pulp necrosis, to remove the periapical inflammation induced by microbial products. When facing cases of external tooth resorption, one's conduct must always respect the following sequence of steps: first of all, identifying the cause accurately; then, planning the therapeutic approach and, finally, adopting the conducts in a very well-founded way. The situations in which endodontic treatment is recommended for tooth resorptions are those when there are: a) pulp necrosis with microbial contamination, b) aseptic pulp necrosis, c) developing calcific metamorphosis of the pulp and d) diagnosis of internal resorption. It is not possible, through the pulp, to control the resorption process that is taking place in the external part, after all, the causes are acting in the periodontal ligament. There is no evidence that justifies applying endodontic treatment, by means of root canal, to control external resorption processes, when the pulp shows vitality. doi.org/10.1590/2177-6709.21.6.020-025.oin Este artigo tem por objetivo principal expor os fundamentos ou razões pelas quais, em casos de dentes com reabsorção dentária externa, incluindo as de origem ortodôntica, não se deve fazer o canal para tratá-la. Isso se faz apenas nos dentes com contaminação ou necrose pulpar, para remover a inflamação periapical induzida pelos produtos microbianos. Frente a casos de reabsorção dentária externa, as condutas devem premiar sempre a seguinte sequência: primeiro, identificar a causa com precisão; depois, planejar a forma de abordagem terapêutica e, por fim, adotar as condutas de forma muito bem fundamentada. As situações em que o tratamento endodôntico está indicado na terapêutica das reabsorções dentárias são quando houver: a) necrose pulpar por contaminação microbiana, b) necrose pulpar asséptica, c) metamorfose cálcica da polpa inicial e d) diagnóstico de reabsorção interna. Não se consegue, por via pulpar, controlar o processo reabsortivo que está ocorrendo na parte externa; afinal, as causas estão atuando no ligamento periodontal. Não há qualquer evidência que justifique fazer o tratamento endodôntico, via canal, para controlar processos reabsortivos externos, quando a polpa está com vitalidade.Palavras-chave: Reabsorção dentária. Reabsorção radicular. Reabsorções externas. Tratamento das reabsorções.orthodontic insight Consolaro A, Bittencourt G

Cross-Sectional Imaging of Third Molar–Related Abnormalities

“…This leads to inflammation and triggers resorption, ultimately resulting in pulp necrosis and loss of the second molars. 27,28 Conversely, entirely unerupted impacted third molars are more likely to be associated with development of cysts and tumors. 29 When reporting an impacted third molar, it is important to assess the relationship with the adjacent second molar, the number of roots and their morphology (convergent, divergent, and/or fused), and in particular the relationship between the tooth and the mandibular canal or maxillary sinus floor.…”

Management of External Inflammatory Root Resorption following Tooth Autotransplantation Using a Modified Combination of Triple Antibiotics

“…Traumatic injuries, replantation of avulsed teeth, intentional (auto)replantation, and autogenous tooth transplantation are amongst factors that could initiate EIRR [ 6 ]. Since EIRR is a deteriorating lesion and could end in the gradual destruction of dental structure and subsequent tooth loss [ 7 ], it should be immediately diagnosed, properly managed, and perfectly treated. Consequently, the treatment of EIRR varies in accordance with the cause and severity of the corresponding resorption and its involvement with the pulpal tissue [ 8 ].…”

Survey based assessment of diagnosis through periapical radiograph and CBCT and treatment of root resorption with Brazilian and American dentists and endodontists

“…On the other hand, external inflammatory root resorption occurs as an imbalance between osteoblasts and osteoclasts present in the periodontal ligament ( 9 ). Since its progression occurs from the external surface of the roots, in some cases, pulp tissue is found intact ( 9 , 10 ).…”

“…On the other hand, external inflammatory root resorption occurs as an imbalance between osteoblasts and osteoclasts present in the periodontal ligament ( 9 ). Since its progression occurs from the external surface of the roots, in some cases, pulp tissue is found intact ( 9 , 10 ). Its etiology includes: orthodontic movements, chronic periapical lesions, occlusal trauma, dental trauma, orthognathic surgery, periodontal treatment and teeth whitening ( 11 ).…”

“…Radiographically, it presents with irregular limits, variations in density within the lesion, and, most of the times, visible root canal walls ( 10 ). If the root canal is affected or the tooth presents with a chronic periapical lesion due to necrosis of the pulp, root canal therapy is indicated ( 9 , 12 ). When the etiology is removed, the affected surface returns to its physiological form due to the cementoblast activity on the external surface of the tooth ( 9 ).…”