Amy Dukoff
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OOTH
RESORPTION may go unnoticed for many years. Often, the patient is
unaware of it because of the lack of symptoms. Usually, the practitioner
will discover the resorption in an unusual radiographic finding upon a
routine examination when periapical radiographs are taken.
Treatment of internal resorption begins with proper
identification. Diagnosis differentiates internal resorption from
external resorption. It is important in treatment to know if the
resorption is purely internal, initiating within the pulp chamber and not
communicating with the periodontal ligament. If the resorptive area
is communicating, then it is an internal-external resorptive case, and
the prognosis is questionable.
Internal resorption can be the result of many factors:
-
partial removal of the pulp
-
caries
-
trauma
-
pulp capping with calcium hydroxide
-
a cracked tooth
The patient’s history will give the practioner clues to when the tooth
was last worked on and whether trauma was involved. The resorptive
process can progress at different speeds and with different periods of
activity.
Internal resorption can be managed with conventional
non-surgical root-canal therapy. Prognosis is good; however, the
patient must be recalled, since the resorptive defect can recur.
If there is a perforation of the root to the periodontal ligament, then
repair must be undertaken to create a barrier. Calcium hydroxide
has osseous reparative properties that make it a good choice to create
a barrier.
Internal resorption is a problem all practitioners
come across in practice. Successful treatment requires proper diagnosis
and a good history. Management and treatment are essential.
November-December 2001
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Management
and treatment are essential.
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