This type of resorption is relatively rare
and may appear clinically as a pink area in the crown of the
affected tooth as shown in Fig 20a. However, the
clinician should recognize that a pink appearance in the
crown of a tooth is indicative of highly vascular
resorbing tissue which has removed sufficient dentine
and enamel to allow it to be visible through the thin
overlying tooth substance. While this may be internal in
origin, particularly if there has been a history of recent
trauma, it more commonly arises from an external
periodontal source. The location of the pink spot is
more likely to be entirely within the crown of the tooth
in internal replacement (invasive) resorption.
Radiographically it may appear as an irregular out-line
within the image of the root canal or as an
extension of it as shown in the oval radiolucency in
Fig 20b. Management consisting of pulpectomy,
curettage of the resorptive defect and root filling will
generally control the resorptive process as illustrated in
Figs 20c-Fig 20d. The long-term follow-up examination
of that treatment is shown in Figs 20e-20f. In more
extensive cases, the resorptive tissue may communicate
with the periodontal ligament and pulpectomy should
be supplemented by the careful topical application to
the defect of 90% aqueous trichloracetic acid on a
small cotton wool pellet (size 00) or a mini-applicator.
This will aid in the inactivation of any communicating
resorptive tissue. Generally, this treatment can be
followed by the insertion of a conventional root filling
although in communicating lesions there may be
occasions where mineral trioxide aggregate (ProRoot
MTA) may be used to advantage in sealing the defect
prior to the placement of a root filling.
and may appear clinically as a pink area in the crown of the
affected tooth as shown in Fig 20a. However, the
clinician should recognize that a pink appearance in the
crown of a tooth is indicative of highly vascular
resorbing tissue which has removed sufficient dentine
and enamel to allow it to be visible through the thin
overlying tooth substance. While this may be internal in
origin, particularly if there has been a history of recent
trauma, it more commonly arises from an external
periodontal source. The location of the pink spot is
more likely to be entirely within the crown of the tooth
in internal replacement (invasive) resorption.
Radiographically it may appear as an irregular out-line
within the image of the root canal or as an
extension of it as shown in the oval radiolucency in
Fig 20b. Management consisting of pulpectomy,
curettage of the resorptive defect and root filling will
generally control the resorptive process as illustrated in
Figs 20c-Fig 20d. The long-term follow-up examination
of that treatment is shown in Figs 20e-20f. In more
extensive cases, the resorptive tissue may communicate
with the periodontal ligament and pulpectomy should
be supplemented by the careful topical application to
the defect of 90% aqueous trichloracetic acid on a
small cotton wool pellet (size 00) or a mini-applicator.
This will aid in the inactivation of any communicating
resorptive tissue. Generally, this treatment can be
followed by the insertion of a conventional root filling
although in communicating lesions there may be
occasions where mineral trioxide aggregate (ProRoot
MTA) may be used to advantage in sealing the defect
prior to the placement of a root filling.