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Amy Beth Dukoff, D.M.D.
Internal Resorption
Amy Dukoff

Amy Dukoff

TOOTH 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 patientís 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
Management and treatment are essential.
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