Goodlettsville Dental Services

Tooth & Root Resorption

Tooth Resorption

Tooth resorption is a process by which all or part of a tooth structure is lost due to activation of the bodies innate capacity to remove mineralized tissue, as mediated via cells such as osteoclasts.

Types include external resorption and internal resorption.

It can be due to trauma, infection, or hyperplasia

External resorption is a condition of a tooth where the root surface is lost. This can be caused by chronic inflammation, cysts, tumors, trauma, reimplantation of a tooth, or sometimes the cause is unknown.

Internal resorption is an unusual condition of a tooth when the dentin and pulpal walls begin to resorb centrally within the root canal. The first evidence of the lesion may be the appearance of a pink-hued area on the crown of the tooth; this condition is referred to pink tooth of Mummery, after the 19th century anatomist James Howard Mummery, and represents the hyperplastic, vascular pulp tissue filling-in the resorbed areas.

The cause can sometimes be attributed to trauma to the tooth, but other times there is no known etiology. If the condition is discovered prior to perforation of the crown or root has occurred, endodontic therapy, known as root canal therapy in lay terms, may be carried out with the expectation of a fairly high success rate.

Root Resorption

In dentistry, root resorption is the breakdown or destruction, and subsequent loss, of the root structure of a tooth. This is caused by living body cells attacking part of the tooth. When the damage extends to the whole tooth, it is called tooth resorption. Severe root resorption is very difficult to treat and often requires the extraction of teeth.

Root resorption occurs as a result of differentiation of macrophages into osteoclasts in surrounding tissue which, if in close proximity to the root surface will resorb the root surface cementum and underlying root dentine. This can vary in severity from evidence of microscopic pits in the root surface to complete devastation of the root surface.

Deciduous root resorption is a natural process which allows exfoliation of the primary teeth to make way for the secondary teeth. Deciduous root resorption is caused by osteoclast differentiation due to pressure exerted by the erupting permanent tooth.

Root resorption of secondary teeth can occur as a result of pressure on the root surface. This can be from trauma, ectopic teeth erupting in the path of the root, inflammation, excessive occlusal loading, aggressive tumours and growths. The most common cause in Western Society is orthodontic forces. (Weiland 2003)

Roots of teeth are covered with cementum. This is a structure that resembles bone. It is however more resistant to resorption than bone. There are a number of theories as to why this is the case. The most common hypothesis is that because cementum is harder and more mineralised than bone and has anti angiogenic properties, blood vessels are inhibited from forming adjacent to cementum which in turn prevents access to osteoclasts.