Sunday, September 7, 2014

Idiopathic resorption

There are many reports of cases in which, despite investigation, no possible local or general cause has been found. The resorption may be confined to one tooth, or several may be involved. The rate of resorption varies from slow, taking place over years, to quick and aggressive, involving large amounts of tissue destruction over a few months. The site and shape of the resorption defect also varies. Two different types of idiopathic resorption have been described.
Apical resorption is usually slow and may arrest spontaneously; one or several teeth may be affected, with a gradual shortening of the root, while the root apex remains rounded. Cervical external resorption takes place in the cervical area of the tooth. The defect may form either a wide, shallow crater or, conversely, a burrowing type of resorption. This latter type has been described variously as peripheral cervical resorption, burrowing resorption, pseudo pink spot, resorption extra camerale and extracanal invasive.
There is a small defect on the external surface of the tooth; the resorption then burrows deep into the dentine with extensive tunnel-shaped ramifications. It does not, as a rule, affect the dentine and predentine in the immediate vicinity of the pulp. This type of resorption is easily mistaken for internal resorption.
Cervical resorption may be caused by chronic inflammation of the periodontal ligament or by trauma. Both types of cervical resorption are best treated by surgical exposure of the resorption lacunae and removal of the granulation tissue. The resorptive defect is then shaped to receive a restoration.