Diagnosis of internal root resorption: clinical manifestations and radiological features.

Abstract

There are several types of internal tooth resorption, each of which has its own etiology, pathogenesis, clinical signs, and radiological features. Each type of resorption can have serious consequences for the tooth and surrounding tissues, so it requires timely and accurate diagnosis, specific treatment strategies, observation and monitoring. The study aimedto represent the clinical manifestationsand diagnostic peculiaritiesof internal root resorption, enabling practicing dentists to timely diagnose lesionsand take appropriate measuresto avoid further complications. Methods. Patients with internal inflammatory root resorption (n=8) and with internal replacement resorption (n=7) were included in the study. The groups were analyzed according to clinical and radiological parameters. Pulp vitality was determined by standard examination methods (inspection, probing, percussion, sensitivity test, EOD). When evaluating X-ray images, the size, localization, and contours of the resorption of hard tooth tissues and/or bone destruction, periapex, and the quality of filling the root canals were considered. Results. Affected teeth with partially vital pulp have caused symptoms and/or signs of acute or chronic pulpitis. Internal inflammatory and internal replacement types of resorption in depulped teeth had similar clinical signs: asymptomatic course, tooth color change, lesions of resorption were detected accidentally during radiographic examination. Most teeth with internal root resorption did not have prior endodontic treatment (86.7%) and had a normal periapex (60.0%). In 14.3% of caseswithinternal replacement resorptionsome ankylosis with reduced mobilitywas revealed. Most of the affected teeth were anterior (53.3%), internal resorption lesions were mainly located in the middle (50.0%) and the lower thirds of the root (37.5%). Radiographically, in inflammatory resorption a symmetric oval-shaped radiolucent enlargement of the root canal with smooth and well-demarcated margins was found; in case of replacement resorption, a round-shaped (ballooning) radiolucency enlargement with an irregularly(cloudy)and/or mottled inclusions of bone-like tissue was detected. Conclusions. Early diagnosis, elimination of the cause, and timely management of root resorption are mandatory for tooth preservation. The main method of diagnosis of internal tooth resorption is radiographic, as the process can proceed without subjective painful sensations. The leading role belongs to dental computer tomography. One of the radiological criteria of pathological tooth resorption is a change in the internal configuration of the root canal.