Operating protocols of external root cervical resorption

Abstract

Aim: Theme of this report is the external cervical root resorption and the sequence of clinical procedures to be implemented during the phases of treatment.The external cervical root resorption (ICR) presents particular pathological conditions such as to classify between resorption of inflammatory origin. 1-3 It is generally presented as a complex clinical situation both in the diagnosis in a predictable prognosis. 3-6 It's often associated with loss of calcified tissue: dentin, cementum, alveolar bone. Often during the treatment the pulp vitality is compromised. [4][5][6][7][8][9][10][11] The etiological factors are vague and not closely associated with the onset of the disease. Prevention is often impossible and treatment modalities not so simple, highly dependent on the location and severity of the injury. 2,3 Key points to get a favorable prognosis of elements with the processes of resorption are: early detection, accurate removal of tissue resorption, endodontic and restorative phases with accurate isolation of the operative field.In the early stages of treatment it is advisable to look for: the specific etiological factor (bleaching, trauma, previous surgery, etc.), the severity of the lesion (extension submarginal, infraosseus; the possible compromise of the vitality of the pulp by means of diagnostic vitality tests. 12,13 A large part of the cervical resorption is not associated with endodontic problems. A conservative approach without sacrificing the vitality of the pulp is then desirable. 8 Cleansing with irrigation endodontic solutions (sodium ipocloroite and clorexidine) can prevent future endodontic diseases. 14 Peer review under responsibility of Società Italiana di Endodonzia.

An Interdisciplinary Approach for Management of Trauma-induced External Root Resorption: A Case Report with a Two-Year Follow-up

“…The problem detection at the beginning of this development, the exact removal of the resorption tissue, endodontic treatment when indicated, and the restoration of the defects with an adequate isolation of the operating field determine the prognosis of the affected tooth. 8…”

External root resorption: diagnosis and treatment. clinical case report

“…Problem detection at the beginning of this development, the exact removal of resorption tissue, endodontic treatment when indicated and restauration of the defects caused by resorption with an adequate isolation of operating field. 19 The treatment of external cervical resorption consists of the removal of all granulation tissue present in the reabsorbed region and in the filling of this region with a material that does not allow the penetration of clastic cells so that it does not injure the periodontal tissue. Typically, in this type of reabsorption, there is no communication of the reabsorbed area with the root canal, so endodontic treatment is not necessary in all cases.…”

“…21 In contrast, periodontal surgery and restoration of resorption defects following the healing of periodontal tissues is also a recommended treatment behavior for preserving pulp vitality. 18,19 In severe external resorptions, in which the pre-dentin layer remains protecting the pulp; it has been suggested that the organic phase of pre-dentin contains an inhibitory enzyme against reabsorption.…”

Desmistificando a Reabsorção Radicular Externa: Revisão Da Literatura.

“…Minuzzi 13 O diagnóstico das reabsorções radiculares é um dos pontos chave para determinar o plano terapêutico. Detecção de problemas no início desta evolução, remoção exata do tecido reabsorvido, tratamento endodôntico quando indicado e restauração dos defeitos causados pela reabsorção com isolamento adequado do campo operatório 17 . O tratamento da reabsorção cervical externa consiste na remoção de toda a granulação tecido presente na região reabsorvida e no preenchimento desta região com um material que não permita a penetração de células clásticas para não lesar o tecido periodontal.…”