Radiological and Histopathological Features of Internal Tooth Resorption.

Magnetic resonance imaging cone beam computed tomography internal root resorption micro-computed tomography pulp histology pulp inflammation

Journal

In vivo (Athens, Greece)
ISSN: 1791-7549
Titre abrégé: In Vivo
Pays: Greece
ID NLM: 8806809

Informations de publication

Date de publication:
Historique:
received: 02 03 2020
revised: 24 03 2020
accepted: 28 03 2020
entrez: 2 7 2020
pubmed: 2 7 2020
medline: 22 6 2021
Statut: ppublish

Résumé

Internal root resorption is an endodontic disease characterized by progressive resorption of dentin from the inside of the pulp chamber. It is a comparatively rare finding in the permanent dentition, and the underlying pathology is not fully understood. A 45-year-old patient was referred to our Department for the evaluation of the lower right canine and the upper left wisdom tooth. Pulp sensitivity tests, cone-beam tomography, and magnetic resonance imaging were used to determine the extent of lesions of the affected teeth. The teeth were subsequently extracted due the extent of the lesions. The same was the case for the upper right canine, which developed a severe internal resorption 10 months later. Micro-computed tomography of the extracted teeth revealed that all lesions had a well-defined border with no evidence of sclerosis or hypomineralization. Pulp stones were evident inside the pulp chamber. Ground sectioning of the upper right canine revealed pulp necrosis and an acute infection that had gradually moved in the apical direction. Large multi-nucleated resorbing cells were found on the dentin surface. Importantly, the apical half of the pulp exhibited comparatively normal tissue without substantial inflammatory changes. Decalcified histology of the upper left wisdom tooth demonstrated a completely different histopathological appearance characterized by chronically inflamed granulation tissue with pseudoepitheliomatous hyperplasia and massive bacterial colonization. Our analyses demonstrate that internal root resorption is a multifaceted dental disease with considerable variability in the rate of the underlying inflammatory changes. Oral surgeons should take this into consideration when evaluating the need for extraction of teeth with internal root resorption.

Sections du résumé

BACKGROUND BACKGROUND
Internal root resorption is an endodontic disease characterized by progressive resorption of dentin from the inside of the pulp chamber. It is a comparatively rare finding in the permanent dentition, and the underlying pathology is not fully understood.
CASE REPORT METHODS
A 45-year-old patient was referred to our Department for the evaluation of the lower right canine and the upper left wisdom tooth. Pulp sensitivity tests, cone-beam tomography, and magnetic resonance imaging were used to determine the extent of lesions of the affected teeth. The teeth were subsequently extracted due the extent of the lesions. The same was the case for the upper right canine, which developed a severe internal resorption 10 months later. Micro-computed tomography of the extracted teeth revealed that all lesions had a well-defined border with no evidence of sclerosis or hypomineralization. Pulp stones were evident inside the pulp chamber. Ground sectioning of the upper right canine revealed pulp necrosis and an acute infection that had gradually moved in the apical direction. Large multi-nucleated resorbing cells were found on the dentin surface. Importantly, the apical half of the pulp exhibited comparatively normal tissue without substantial inflammatory changes. Decalcified histology of the upper left wisdom tooth demonstrated a completely different histopathological appearance characterized by chronically inflamed granulation tissue with pseudoepitheliomatous hyperplasia and massive bacterial colonization.
CONCLUSION CONCLUSIONS
Our analyses demonstrate that internal root resorption is a multifaceted dental disease with considerable variability in the rate of the underlying inflammatory changes. Oral surgeons should take this into consideration when evaluating the need for extraction of teeth with internal root resorption.

Identifiants

pubmed: 32606158
pii: 34/4/1875
doi: 10.21873/invivo.11983
pmc: PMC7439852
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1875-1882

Informations de copyright

Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

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Auteurs

Till Koehne (T)

Department of Orthodontics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany tkoehne@uke.de.

Jozef Zustin (J)

Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Michael Amling (M)

Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Reinhard E Friedrich (RE)

Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

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