MULTIPLE IDIOPATHIC EXTERNAL ROOT RESORPTION /endodontic courses
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MULTIPLE IDIOPATHIC EXTERNAL ROOT RESORPTION /endodontic courses
- 1. MUTIPLE IDIOPATHIC EXTERNAL ROOT RESORPTION- A CASE REPORT INDIAN DENTAL ACADEMY Leader in continuing Dental Education www.indiandentalacademy.com
- 2. INTRODUCTION Resorption is a process in which the structure of bone or teeth undergoes destruction due to osteoclastic activity. If resorption occurs in bone the cells are called osteoclast, if resorption occurs in tooth it is called odontoclast. The resorbing cell osteoclast is a multinucleated giant cell formed by fusion of mononuclear cells derived from haemopoietic stem cells. The resorbing cells on tooth surface are smaller than those on bone with few nuclei. www.indiandentalacademy.com
- 3. Resorption may be- a)Physiological b)Pathological c)Idiopathic physiological resorption is the resorption of root in deciduous tooth for eruption of permanent teeth. Pathological resorption is due to pressure of pathological condition on root. Resorption of permanent teeth was first described by BATES in 1856. www.indiandentalacademy.com
- 4. TOOTH ROOT RESORPTION INTERNAL RESORPTION Internal surface of dentinal walls and pulp chamber EXTERNAL RESORPTION Root surfaces www.indiandentalacademy.com
- 5. EXTERNAL RESORPTION External resorption occurs at the external surface of root as a result of tissue reaction in the periodontal or pericoronal tissue and increasing in osteoclastic activity in response to various stimuli. www.indiandentalacademy.com
- 6. FACTORS ASSOCIATED WITH EXTERNAL ROOT RESORPTION • Cysts • Tumours • Dental trauma • Periapical inflammation • periodontitis • Orthodontic therapy • Pressure from impacted tooth • Reimplantation of tooth • Endocrine disturbances • idiopathic www.indiandentalacademy.com
- 7. IDIOPATHIC EXTERNAL ROOT RESORPTION • Idiopathc root resorption can be internal or external. • Idiopathic external root resorption is the term used when the condition exists with out a known etiology. (Belanger & Coke-1985) • This condition was first reported by Mueller and Rony in 1930. • It is a rare condition that has been reported in single and multiple teeth. • Two types have been observed : apical and cervical (Lydiatt et al. 1989, Yusof & Ghazali 1989) • Here a rare case of multiple idiopathic resorption of fourteen teeth in the jaw is detected and presented . www.indiandentalacademy.com
- 16. INTRA ORAL PERIAPICAL RADIOGRAPH ORTHOPANTOMOGRAM LATERAL SKULL RADIOGRAPH www.indiandentalacademy.com
- 20. RIGHT MAXILLARY PREMOLARS AND MOLARS IOPA www.indiandentalacademy.com
- 21. LEFT MAXILLARY PREMOLARS AND MOLARS IOPA www.indiandentalacademy.com
- 26. An Overview RESORBED TOOTH AREA INVOLVED 11 COMPLETE ROOT 12 COMPLETE ROOT 15 CERVICAL REGION 16 APICAL 1/3rd 24 APICAL 1/3rd 25 APICAL 1/3rd 26 APICAL 1/3rd 34 CERVICAL REGION 35 UP TO MIDDLE 1/3rd & CERVICAL REGION 36 APICAL 1/3rd & CERVICAL REGION 41 COMPLETE ROOT 42 COMPLETE ROOT 44 CERVICAL REGIONwww.indiandentalacademy.com
- 28. BIOCHEMICAL INVESTIGATIONS • Serum alkaline phosphatase- Result: 161 IU/L • Serum calcium- Result: 8.3 mg/dl www.indiandentalacademy.com
- 32. MULTIPLE IDIOPATHIC EXTERNAL ROOT RESORPTION www.indiandentalacademy.com
- 33. DISCUSSION • Idiopathic external root resorption is seen most commonly in young adult males(Moazami & Karami,2007) • It does not seem to be mediated from the pulp space. It is suspected that triggering factors exist for osteoblastic and odontoblastic activity producing root resorption(Rivera & Walton 1994). www.indiandentalacademy.com
- 34. Cont……. • Special mechanisms in the periodontal ligament exist to prevent mineralization of the periodontal ligament and these periodontal ligament cells produce factors that inhibit mineralized tissue resorption and are capable of regulating bone and cementum formation (Beertsen et al. 1997, McCulloch et al. 2000) • Felix et al (1998) hypothesized that increased releasing of colony stimulating factor by the osteoblast in response to IL-1, TNF-α and TNF-β may provide a signal for the growth and maturation of osteoclast precursor cells leading to subsequent bone resorption. Such a sequence of event may occur in the periodontal ligament. www.indiandentalacademy.com
- 35. CONCLUSION The present case is considered to be multiple idiopathic external root resorption because none of the known causes can be attributed to the presence of multiple external resorptions. An understanding of clinical and radiographic features will aid in the early diagnosis and treatment of this destructive process. Nevertheless, an ultimate goal to find the causative factors and institute preventive measures. www.indiandentalacademy.com