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Resorption due to ortho
From: Marga Ree
To: ROOTS
Sent: Friday, April 10, 2009 12:49 AM
Subject: [roots] ortho= controlled trauma..
I see more and more resorption due to ortho. This 45 year old
male was referred to retreat 11. He had a sinus tract at the
buccal aspect of 11. Tooth was calcified.
I probably made my own canal, filled with CaOH and after some
time MTA, did an internal belaching, but the sinus tract never
went away.
Surgery revealed a missing buccal bone plate....and there was
calculus on the root tip. Funnely enough, I see this frequently
when there is a long standing sinus tract.
I covered the resection surface with composite, and gave him a
poor prognosis, given the extremely poor root/crown ratio and
missing buccal bone plate.
Today he returned after 6 months, the sinus tract was gone,
and there are even signs of healing, the lesion is filling in.
Patient is symptomfree, his dentist splinted all front teeth
with a retention wire - Marga
Dear Marga,
Your patients are definitely lucky to stay in your hands.
There is a right scar from #7 to #9 over the mucogingival line
at the starting. It suggest to me a previous trauma or surgery
in the area. Was there any antecedent of this type?
Even in this case it seems root resorption that happens
from #7 to #10.
Do you have details on the Ortho treatment: speed, lasting,
technique? Have you arrived to any conclusion about which ortho
procedures or patient conditions could lead to resorption?
On the other hand, I have a multidisciplinary patient, who is
finishing the orthodontic stage and she is referred to make RCT
from #6 to #11 in sound pulps previous to prosthetic
rehabilitation. I am concerned on the risk of external
resorption due that periodontal ligament is enlarged for recent
ortho movement.
Do you know any experience or advice on this cases?
Do you wait some time to start RCTs? - Nuria Campo
Hi Nuria,
Patient mentioned a previous surgery some years ago. I assume
an oral surgeon did an attempt to control the infection,
without success.
Ortho was initiated some years ago, with catastrophic root
resorption in all teeth, in particular upper and lower
front teeth.
Do you have any radiographs from this patient of yours?
Why should all these teeth be root canal treated, since
you are mentioning the presence of healthy pulps?? - Marga
Hi Marga, Am I correct that you see the root tip calculus often
when doing surgery on long-standing lesions? If so, I remember
John Stropko describing the same thing. I would imagine the
apexum device would have little effect, no? - Kendel
Yes, Kendel, you are correct, that's my experience as well, in
particular in the presence of long standing sinus tracts.
Extraradicular biofilms do exist....:-)) No apexum device
for me here! - Marga
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