Invasive cervical resorption - Courtesy ROOTS
The opinions and photographs within this web page are not ours.
Authors have been credited |
for the individual posts where they are.
- Photos courtesy of Winfried - www.rxroots.com
From: "Winfried Zeppenfeld"
Sent: Monday, December 08, 2008 2:42 AM
Subject: [roots] Distal translucency?
In 1994 I prepped a bridge in the right mandible of this pt.
I was quite surprised I opened the pulp of 45 (#29 US),
way more coronally than I ever expected. I did rct
(steel files , AH26 and lateral condensation)
and cemented a cast post. In 1994, I concluded it was some
kind of internal resorption but didn't take a closer
look at the mid root area due to lack of knowledge.
When I look at these pics today, it sure looks
like internal rsorption. May also be an extra canal,
although the recent mesial excentric X-ray gives no hint of a
sencond pdl. Yesterday, the pt came with a swelling that
corresponds with the lateral lesion visible on the X-ray.
There must be a connection between the lesion and the marginal
gingiva, although I could not probe it. But when I blew air at
the margin, my fingertip placed above the lesion felt the
mucosa blow up like a little balloon. What should I do now?
46 and 47 are missing, and 45 is quite a weak abutment for such
a long bridge. So my idea is to take 45 out and place two
implants in the location of 45 and 47. The crown on 48 can stay
there. Would anyone of you recommend retreatment of 45 and dare
to place a new bridge? Any other ideas? - Winfried
Win, This is invasive cervical resorption, no internal resorption.
Prognosis is very poor in this case - Marga
Hi Winfried, for a internal resorption, you got to have a vital
pulp. So even if there would have been a second canal, I am not
sure, if the pulp would have survived for so long - Jörg
Winfried....this is ECIR, unfortunately.- Fred
I agree with Marga, this is an external resorption, meaning the
resorptive cells are from the pdl. Internal resorption is rare in
comparison, and the resorptive cells are from the pulp, so even
if a canal was missed, the pulp would have had to remain vital to
cause this defect---not so likely. Also, the external
variety seems to be more 'malignant", and this prognosis looks
quite poor, as Marga said, perhaps a Heithersay III or IV already.
This is commonly called cervical resorption, although this
terminology is not so precise, since the process does not always
present at the cervical, as we see here - Kendel
Thanks Marga (and Fred, Jörg, Kendel)
At least I didn't srew up the prognostic evaluation of the tooth.
Anyway, I'm surprised it lasted that long. Thanks for your help!
Here is another one from 1984. Any objections that it is internal?