Dental Reabsorptions

Abstract

Dental reabsorptions can be classified as being caused by trauma, infection, or by a hyperplastic invasive, often idiopathic process. Objectives: The aim of this paper is to classify all types of dental reabsorptions based on their etiology. It will describe their pathogenesis, histologic manifestations, risk factors, and clinical or radiological appearance, stressing the importance of radiological imaging for early diagnosis. It will also provide the different treatment protocols for the most common resorptions and will allow the clinician to be able to perform a differential diagnosis between them and to be prepared to correctly identify and manage them. Methodology: Research on the topic was carried out through Pubmed and Wiley Online Library, through which appropriate articles, books, and international well-known dentistry journals were found. 30 articles have been used, all written in English language and within the last decades. Discussion: Internal inflammatory resorptions are treated by root canal treatment with emphasis on total removal and subsequent complete obturation of the resorptive defect. Invasive cervical resorptions are handled differently depending on their Heithersay class. For the simpler ones removal of the resorptive and granulation tissue through curettage and application of 90% trichloroacetic acid is enough. External inflammatory resorptions are managed by performing pulpectomy and use of intracanal medicaments such as Ledermix paste or Calcium Hydroxide. Orthodontic resorption is treated by ceasing the forces applied temporarily and monitoring the evolution. Replacement resorption cannot be treated. Conclusions: Dental reabsorptions are physiological in the primary dentition and pathological in the permanent one. Risk factors include trauma, orthodontic treatment, caries, or presence of impacted teeth or tumors. Resorptions are performed by odontoclasts. They have a slow and generally asymptomatic evolution, for which they can be promptly diagnosed by routine radiographs. Their exact location and extent can be determined through cone beam computed tomography imaging.