Generalized cervical root resorption associated with periodontal disease
Wouter Beertsen1, Mahé Piscaer1, Arie Jan Van Winkelhoff2 and Vincent Everts1,3

1 Departments of Periodontology; 2 Oral Biology, Academic Center for Dentistry
Amsterdam (ACTA), Louwesweg 1, 1066 EA Amsterdam, The Netherlands; 3 Department of
Cell Biology and Histology, Academic Medical Center Amsterdam

Abstract 

Background and description of case: The etiology and pathogenesis of generalized
cervical root resorptions is not well understood. In the present report, a case of
severe cervical root resorption involving 24 anterior and posterior teeth is
presented. The lesions developed within a period of 2 years after the patient had
changed to an acid-enriched diet. They extended far into the coronal dentin and were
associated with gingival inflammation and crestal bone resorption. However, no
generalized clinical attachment loss had occurred. Culturing of subgingival plaque
revealed the presence of several putative periodontal pathogens among which
Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Treatment consisted
of mechanical debridement supported by systemic antibiotics (amoxycillin plus
metronidazole) and dietary advice.

Results: Within 1 year after the onset of treatment, all resorptive lesions had
repaired by ingrowth of a radio-opaque mineralized tissue. The crestal areas showed
radiological evidence of bone repair. 3 years after the onset of therapy, one premolar
was extracted and examined histologically. It appeared that irregularly-shaped masses
of woven bone-like tissue had invaded into the domain of the resorbed coronal dentin
and were bordered by thin layers of acellular cementum.

Conclusion: It is concluded that, in this patient, the cervical resorptions
were likely the result of an osteoclastic response extending into the roots because
the root-protective role of the junctional epithelium did not develop. We hypothesize
that this was due to the combined effects of a periodontopathogenic microflora and a
dietary confounding factor.

Key words: root resorption; periodontal disease; cementum; periodontal healing;
dietary factors
Courtesy: Fred Barnett, www.rxroots.com