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      Root Resorption Diagnostic: Role of Digital Panoramic Radiography

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          Abstract

          Introduction: Root resorption is a pathological process characterized by loss of dental root substance, caused by bacterial infections, traumatic injuries or chemical irritation. Root resorption might be accidentally observed on digital panoramic radiography. Objective: The objective of the study was to identify characteristic radiological aspects for the different types of root resorption that could be observed on digital panoramic radiography, to make an easier diagnostic of root resorption. Material and Method: The retrospective study used the X-ray base from the Oral Rehabilitation and Dental Prosthetics Clinic of UMF Craiova to identify the most representative images for different types of root resorption. Digital panoramic radiographies were analysed by two investigators, of which the most suggestive images were selected and described. Results: Digital panoramic radiographies and dental charts of 240 patients were analyzed. 113 cases of root resorption were identified. External inflammatory root resorption (EIRR) was present in 27.07% of studied cases, external cervical root resorption (ECRR) was identified in 10.83% of all studied cases, external replacement root resorption (ERRR) was diagnosed in 7.08% of studied cases and internal root resorption (IRR) was the most rare type of root resorption, with only 2.08% from all studied cases. 16 cases were selected to describe the radiologic features of different types of root resorption, featuring the most interesting images of root resorption evident on digital panoramic radiographies. Discussion: Comparative analyses have been made between our results and the results of other specific studies, with both similar and different values. The radiological features which lead to the diagnostic of each type of RR were highlighted, assessing the causes that caused the lesions, as well as the treatment recommendations. Conclusions: Digital panoramic radiography is a useful tool to identify root resorption, since it has become the most common radiological investigation for diagnostic in dentistry. Description of radiological aspects of different types of root resorption on panoramic digital radiography allows faster diagnosis. Still, the CBCT may be recommended in some cases to confirm the diagnosis.

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          Most cited references43

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          Root resorption--diagnosis, classification and treatment choices based on stimulation factors.

          Etiology of different types of root resorption requires two phases: mechanical or chemical injury to the protective tissues and stimulation by infection or pressure. Injury can be similar in various types of root resorption. The selection of proper treatment is related to the stimulation factors. Intrapulpal infection is the stimulation factor in internal root resorption and external periradicular inflammatory root resorption. Adequate root canal treatment controls intrapulpal bacteria and arrests the resorption process. In cervical root resorption, infection originates from the periodontal sulcus and stimulates the pathological process. As adequate infection control in the sulcus is unlikely, removal of granulation tissue from the resorption lacuna and sealing are necessary for repair. Removal of the stimulation factor, i.e. pressure, is the treatment of choice in root resorption related to pressure during orthodontic treatment, or an impacted tooth or tumor. In ankylotic root resorption, there is no known stimulation factor; thus, no predictable treatment can be suggested. Therefore, various types of root resorptions can be classified according to the stimulation factors: pulpal infection resorption, periodontal infection resorption, orthodontic pressure resorption, impacted tooth or tumor pressure resorption, and ankylotic resorption.
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            Root resorption--etiology, terminology and clinical manifestations.

            L Tronstad (1988)
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              Root resorption after orthodontic treatment: Part 2. Literature review.

              All permanent teeth may show microscopic amounts of root resorption that are clinically insignificant and radiographically undetected. Root resorption of permanent teeth is a probable consequence of orthodontic treatment and active tooth movement. The incidence of reported root resorption during orthodontic treatment varies widely among investigators. Usually, extensive resorption does not affect the functional capacity or the effective life of the tooth. Most studies agree that the root resorption process ceases once the active treatment is terminated. Root resorption of the deciduous dentition is a normal, essential, and physiologic process. Permanent teeth have the potential to clinically undergo significant external root resorption when affected by several stimuli. This resorptive potential varies in persons and between different teeth in the same person. This throws doubt on the role of systemic factors as a primary cause of root resorption during orthodontic treatment. Tooth structure, alveolar bone structure at various locations, and types of movement may explain these variations. The extent of treatment duration and mechanical factors definitely influence root resorption. In most root resorption studies, it is not possible to compare the results and conclusions because of their different methods. Further research in this field is necessary to advance the service of the specialty. The question of whether there is an optimal force to move teeth without resorption or whether root resorption may be predictable remain unanswered. This review indicates the unpredictability and widespread incidence of the root resorption phenomenon.(ABSTRACT TRUNCATED AT 250 WORDS)
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                Author and article information

                Journal
                Curr Health Sci J
                Curr Health Sci J
                CHSJ
                Current Health Sciences Journal
                Medical University Publishing House Craiova
                2067-0656
                2069-4032
                Apr-Jun 2019
                30 June 2019
                : 45
                : 2
                : 156-166
                Affiliations
                [1 ]Department of Oral Rehabilitation, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania
                [2 ]PhD Student, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania
                [3 ]Department of Prosthetic Dentistry, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania
                [4 ]Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania
                Author notes
                Corresponding Author: Alexandra Carina Bănică, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova Petru Rares str, no 2-4 Craiova Romania karinabanica@ 123456yahoo.com
                Article
                2019.02.05
                10.12865/CHSJ.45.02.05
                6778303
                31624642
                3391ab9a-ce76-46d3-b8d9-9a68016e1e33
                Copyright © 2019, Medical University Publishing House Craiova

                This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.

                History
                : 30 May 2019
                : 15 June 2019
                Categories
                Original Paper

                root resorption,diagnostic,digital panoramic radiography

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