Root resorption is a cell mediated autoimmune reaction that ultimately leads to tooth root damage. It's a very poorly understood phenomenon in dentistry, but is thought to be caused by cells adjacent to (external resorption) or within (internal resorption) the tooth root. If not detected early, or if treated too conservatively (as was the case here, by placing a filling in the resorption defect as if it were a cavity caused by tooth decay), a periodontal ("gum") infection can occur which will ultimately cause bone damage.


This case was referred to me by a good general dentist in the community who has some training and surgically places implants in his practice, but referred this one out due to the complexity. A very smart decision because these situations can potentially become disasters since they're in the "smile zone".



This patient is in her 20's and has no other significant dental problems other than the severe infection over the upper right central incisor tooth as evidenced by the draining abscess (the red swelling over her "gum"). She also has a missing tooth on her lower left that would benefit from a tooth implant.

The dark spot in the middle of the tooth on the x-ray image represents a "hole" in the root caused by the root resorption. Periodontal ("gum") pocket depths were up to 8mm on both the buccal and lingual (front and back) of the tooth suggesting about 4mm of bone loss.

The challenge will be to extract the tooth, repair the bone damage, and minimize or prevent the gum shrinkage that usually occurs with these types of cases.

You can read more about how to successfully treat these cases in an article that I published about 5 years ago.

http://www.ncbi.nlm.nih.gov/pubmed/16463907?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel