Open Access Open Access  Restricted Access Subscription Access

An Essential Parameters of Internal Root Resorption a Rare Complication of Vital Pulp Therapy with the Help of Platelet-Rich Fibrin Include Treatment, Diagnosis and Discussion

Srinivas G., Ramanjaneyulu D. V., Satyanarayana Murthy S., Muralinath E., Guruprasad M., Hari Kiran M., Shaik Mahabooob Basha, Kundara Giridhar Reddy, Kasireddy Gautami, Mopoori Kalyan, Sai Charan B., Sainath Reddy T., Ramesh U., Rahul P., Rajitha V.

Abstract


A rare side effect of vital pulp therapy (VPT) is internal root resorption (IRR), a damaging process in which clastic cells, triggered by pulpal inflammation, dissolve dentin from within the tooth's pulp chamber or root canal. Cone-beam computed tomography (CBCT) is commonly used for diagnosis, and early discovery, elimination of the underlying cause, and proper treatment—such as filling the resorptive defect with a substance like Biodentine—are necessary for successful management.

What is Internal Root Resorption?

  • Process: As clastic cells eat away at the dentin and dentinal tubules, IRR causes the gradual internal loss of root dentin.
  • Cause: Although other causes may also play a role, pulpal inflammation or damage is frequently the initial cause.
  • Clinical Signs: A tooth with internal resorption may seem pink because of the increased visibility of blood vessels through the thinning dentin, even though it is frequently asymptomatic and found during normal dental checkups.

Internal Root Resorption and Vital Pulp Therapy 

         ·            Complication:After a vital pulp treatment (VPT) surgery, IRR is regarded as a rare but dangerous consequence.

         ·            Management: A case study describes how Biodentine was used to fill the resorptive defect following a platelet-rich fibrin (PRF) pulpotomy, successfully managing IRR. A year-long follow-up revealed a favorable result.

Diagnosis and Treatment

  • Diagnosis: Cone-beam computed tomography (CBCT), a type of advanced imaging that clearly displays the smooth, well-defined radiolucent area of the expanded pulp space, is essential for correctly diagnosing IRR.
  • Treatment: A successful outcome depends on early diagnosis and action. Depending on how severe the lesion is, treatment options may include root canal therapy to seal the resorption, particularly if there has been a perforation or the tooth structure is severely compromised.

 


Full Text:

PDF

References


Tang, W., Wu, Y., & Smales, R. J. (2010). Identifying and reducing risks for potential fractures in endodontically treated teeth. Journal of Endodontics, 36(4), 609–617. https://doi.org/10.1016/j.joen.2009.12.002

Trope, M. (2008). Regenerative potential of dental pulp. Journal of Endodontics, 34(7 Suppl), S13–S17. https://doi.org/10.1016/j.joen.2008.04.001

Hargreaves, K. M., Giesler, T., Henry, M., & Wang, Y. (2008). Regeneration potential of the young permanent tooth: What does the future hold? Journal of Endodontics, 34(7 Suppl), S51–S56. https://doi.org/10.1016/j.joen.2008.02.032

Biehl, J. K., & Russell, B. (2009). Introduction to stem cell therapy. Journal of Cardiovascular Nursing, 24(2), 98–103. https://doi.org/10.1097/JCN.0b013e318197a6a5

Mousaei Ghasroldasht, M., Seok, J., Park, H. S., Liakath Ali, F. B., & Al-Hendy, A. (2022). Stem cell therapy: From idea to clinical practice. International Journal of Molecular Sciences, 23(5), 2850. https://doi.org/10.3390/ijms23052850

Goldberg, M. (Ed.). (2014). The dental pulp: Biology, pathology, and regenerative therapies. Springer.

Berman, L. H., & Hargreaves, K. M. (2020). Cohen’s pathways of the pulp (12th ed.). Elsevier.

Goldberg, M., Kulkarni, A. B., Young, M., & Boskey, A. (2011). Dentin: Structure, composition and mineralization. Frontiers in Bioscience (Elite Edition), 3(2), 711–735. https://doi.org/10.2741/e281

Nanci, A. (2017). Ten Cate’s oral histology: Development, structure and function (9th ed.). Elsevier.

Holland, G. R. (1994). Morphological features of dentine and pulp related to dentine sensitivity. Archives of Oral Biology, 39(Suppl), 3S–11S. https://doi.org/10.1016/0003-9969(94)90182-1

Marion, D., Jean, A., Hamel, H., Kerebel, L. M., & Kerebel, B. (1991). Scanning electron microscopic study of odontoblasts and circumpulpal dentin in a human tooth. Oral Surgery, Oral Medicine, Oral Pathology, 72(4), 473–478. https://doi.org/10.1016/0030-4220(91)90563-R

Mitsiadis, T. A., De Bari, C., & About, I. (2008). Apoptosis in developmental and repair-related human tooth remodeling: A view from the inside. Experimental Cell Research, 314(4), 869–877. https://doi.org/10.1016/j.yexcr.2007.11.001

Murray, P. E., About, I., Lumley, P. J., Franquin, J. C., Remusat, M., & Smith, A. J. (2000). Human odontoblast cell numbers after dental injury. Journal of Dentistry, 28(4), 277–285. https://doi.org/10.1016/S0300-5712(99)00078-0

Couve, E. (1986). Ultrastructural changes during the life cycle of human odontoblasts. Archives of Oral Biology, 31(10), 643–651. https://doi.org/10.1016/0003-9969(86)90093-2

Gotjamanos, T. (1969). Cellular organization in the subodontoblastic zone of the dental pulp. II. Period and mode of development of the cell-rich layer in rat molar pulps. Archives of Oral Biology, 14(9), 1011–1019. https://doi.org/10.1016/0003-9969(69)90071-5

Kim, S., Dörscher-Kim, J. E., & Liu, M. (1989). Microcirculation of the dental pulp and its autonomic control. Proceedings of the Finnish Dental Society, 85(4–5), 279–287.

Iijima, T., & Zhang, J. Q. (2002). Three-dimensional wall structure and the innervation of dental pulp blood vessels. Microscopy Research and Technique, 56(1), 32–41. https://doi.org/10.1002/jemt.10007

Takahashi, K., Kishi, Y., & Kim, S. (1982). A scanning electron microscope study of the blood vessels of dog pulp using corrosion resin casts. Journal of Endodontics, 8(3), 131–135. https://doi.org/10.1016/S0099-2399(82)80249-5

Marion, D., Jean, A., Hamel, H., Kerebel, L. M., & Kerebel, B. (1991). Scanning electron microscopic study of odontoblasts and circumpulpal dentin in a human tooth. Oral Surgery, Oral Medicine, Oral Pathology, 72(4), 473–478. https://doi.org/10.1016/0030-4220(91)90563-R

O'Rahilly, R., & Müller, F. (1994). Neurulation in the normal human embryo. In Ciba Foundation Symposium (Vol. 181, pp. 70–82). Wiley. https://doi.org/10.1002/9780470514559.ch5


Refbacks

  • There are currently no refbacks.