This document discusses root resorption, including its causes, treatment, and relationship to pulpal infection and other dental procedures. It notes that root resorption can be caused by pressure, infection, chemicals, mechanical trauma, or unknown factors. Treatment involves removing the stimulus, such as through endodontic therapy or surgery. If the stimulation is small, repair may occur, but large stimulation can lead to replacement resorption or ankylosis. The document provides guidance on treating different patterns of internal or external resorption depending on pulpal health and location on the root.

1. Root Resorption
Cezar Edward Lahham (BDS)

3. etiology
 1- pressure “increase or decrease “
 2- infection
 3- chemicals “ e.g : 30% H2O2”
 4- mechanical
 5- unknown

4. Treat it easily by removing the cause !

5.  The resorption is done in 2 phases :
1- Injury
2- Stimulation
Injury takes many forms “ pressure , inf. , ..etc “
Injury to “PDL , cementum , predentine , internal wall of the root surface.. “
will make a stimulation !!!
If the stimulation is limited & small  repair will happened within 2-3 wks
If the stimulation is large  Unable to repair  direct contact btw bone &
cementum  Replacement resorption =Ankylosis

6. Internal or External resorption due to
pulpal infection :
 If the resorption happened internally ,, the way of thinking is to STOP the blood supply to the
OSTEO/Odontoclasts !!  Endo tx  so the resorption will STOP!
We open the access & clean the canals  then put nonsetting CaOH for 6-24 months
CaOH : - increase ph of the dentine “8-10”  inhibits activity of osteoclastic acid hydrolases &
activate alkaline phosphatase .
- Reduce permeability of hydroxyl ions through D. tubules.
- -Antimicrobial activity “ but less than IKI , CHX ,copper “
- Studies shows that use 5% CHX is more Antimicrobial activity than CaOH
- So the new IC medicament is Activ point which contains CHX “AB activity for depth 0.5 mm”

8.  If the resorption is externally in the lower half of the root surface & the tooth
is pulpally infected  we suggest that the cause is osteo-odontoclastic
activity “stimulated by pulpal infection by dentinal TUBULES , accessory ,
Lateral canals & apical foramen !! “  so think to STOP the blood supply &
Remove the stimuli  Endo tx
 If the resorption is externally in the lower half of the root surface & the tooth
is sound  we suggest that the cause is osteo-odontoclastic activity
“stimulated by mechanical trauma or ortho  remove the cause
 If the resorption is externally on the upper half of the root surface  Check
the tooth  if sound  external curettage

9. Periodontal infection & R.R

10.  In these cases “Cervical resorption”:
we MUST expose the area of resorption “By surgery or Ortho”
Then Curettage to remove granulation tissue “stimuli”
Then restore the cavity ..
Endo Tx NOT NECESSARY UNLESS there is perforation to Root Canal …

11. Impacted tooth & R.R
 Stimuli by pressure of “ impacted tooth , Cyst , Fibroossuos lesions ,
ameloblastoma ,, etc”
 Impacted Upper Canine  upper Lateral
 Impacted Lower wisdom  lower 7
 We Must remove the cause SURGICALLY.
 Prognosis is GOOD

12. Ortho tx & R.R
 Happened in the root apex
 Tx: Just remove the stimuli for 2 wks then continue with lower force

13. Replacement resorption : Ankylosis
 Happened commonly with Avulsed tooth when the EO dry time >60 min
 The resorption areas are replaced and filled with bone tissues
 So in these cases before we re-implanted the tooth ,we soak it in Fluoride for
15-20 min which can slow the rate of ankyloses
 NO TREATMENT IS DONE IF ANKYLOSIS WAS HAPPENED : Because No stimuli
could we remove !!!

14. references
 J Endod 1997 ;23(12):768-73
 Tronstad L. Root resorption 1988 4:241-52
 AAER Giudeline 1995

15. Thank You
 Best Wishes