Dental Resorption: Understanding the Underlying Causes

Dental resorption defined is when the body cells aggress and destruct part of a tooth. It is not exactly known why cells attack their own tooth, but it’s sometimes related to quite a number of factors. One of a number of things is that dental resorption is classified according to causation or groups in order to implement proper management. Understanding the underlying pathology plays a significant role in the diagnosis and very vital in treatment planning or objective management.

Depending on what area the resorption takes place, coming from the inner surface, it is known as internal resorption. Living cells in the tooth attack and wear away its lining, starting from the top of the root canal and slowly but progressively spreads without pain, resulting from insults or trauma that irritates some of the cells. Once the inside cavity of the pulp chamber of the tooth crown and the root canal are damaged, these are taken out utilizing root canal therapy in the early stage.

From the outer surface; enamel or the cementum where a tooth is engrafted and surrounded by a bone, then builds its way through the inner tooth’s root, it’s external resorption. This is worse because it usually has an inadequate dental prognosis and ends up with tooth extraction.

Limited to the tooth root, whether it is attacked from the inside out or vice versa, it is root resorption. The inflammatory killer cells aggress the tooth root and eat it up the same way they do foreign bodies. If the damage is internal, it would be somewhat hard to treat for they create round spaces inside the root that root canal instruments cannot clean out. If the damage is external, it ends up with tooth extraction.

Wherever these resorptions may occur, it’s not at all a good sign. Technically, tooth resorptions can also be grouped according to causation, but we can speak of the same thing, internal and external root resorptions.

Trauma induced is a result of force from erupting or about-to-erupt teeth, pressure from orthodontic devices, mechanical displacements or avulse injuries or can be as a result of surgical, thermal or chemical trauma that damage the cementoid membrane. This may occur on the surface, oftentimes non-infectious, short-lived, with presence of teeth discoloration and involves a small amount of dentine then the apical closure follows. Trauma-induced resorption can also be caused by a progressive replacement of an alveolar bone that causes death of periodontal tissues due to drying out and compaction, for example, delayed implantation of separated tooth.

Infection induced can be internal, external and a combination of both and widely varies in intricacy. This is usually caused by dento-alveolar implant device. Manifestation is inflammation due to infectious endodontic pathology. Control and treatment can be through the use of anti-clastic curative agents to activate hard tissue development on the resorbed root surface.

Hyperplastic invasive resorption is beguiling, aggressive, and harmful compared to the other two. Tissues undergoing resorption encroach upon the tooth’s hard tissues in an ostensibly loose fashion resembling that of fibro-osseous injury, causing not just insults but also cataclysmal. Guarding its progress related to what caused the lesion cannot be done by simple excretion. It can be recurring and has the tendency to spread by creating small infiltration routes within the dentine and complex with the periodontal ligaments distal to the resorption. Origin can be internal or external and total removal or deactivation of the resorptive tissue is absolutely necessary.