By: Lee Ann Brady, DMD
This topic originally appeared on PankeyGram.Org. Dr. Brady granted igniteDDS permission to share with our readers.
Root resorption is a phenomenon that takes on various forms, each with unique implications for the long-term health of a tooth. Among these, pressure root resorption stands out as a common type.
This occurs when pressure from an adjacent tooth, typically one that is erupting or impacted, exerts force on the root of another tooth, leading to localized root resorption.
Classic Scenarios of Pressure Root Resorption
Pressure root resorption frequently appears in well-recognized patterns:
- Distal of Second Molars:ย One of the most common sites is the distal root of the second molar. While itโs easy to attribute this damage to surgical removal of impacted third molars, the actual culprit is often the impacted third molarโs crown pressing against the second molarโs root during the eruption.
- Upperย Anterior Teeth:ย Other common sites are at the roots of upper anterior impacted teeth, due to the impingement of impacted canines.
The Good News: Resorption Stops with Pressure Removal
A critical factor to understand about pressure root resorption is its self-limiting nature. Once the source of the pressure is removedโwhether through orthodontic treatment or oral surgery interventionโthe resorption ceases. More importantly, it does not recur after the pressure is alleviated.
Prognosis and Clinical Considerations
Patients diagnosed with pressure root resorption generally enjoy a favorable long-term prognosis. Despite the abnormal appearance of the affected root on radiographs, clinical evidence suggests there is minimal risk to pulp vitality.
Unlike other forms of resorption, pressure-induced resorption rarely jeopardizes the toothโs pulp vitality. Although the tooth cannot regenerate lost cementum, this lack of repair does not necessarily compromise the toothโs overall longevity.
Oral Surgery Procedures and Orthodontic Risks
While addressing the root cause is essential, clinicians should be mindful of other potential risks, such as reduced blood supply to the tooth. This complication is more likely during oral surgery removal of impacted third molars or the exposure of maxillary canines.
Prevention and Management of Root Resorption
Managing pressure root resorption begins with early detection through regular radiographic monitoring, especially in patients with known risk factors such as impacted teeth. Prompt intervention to relieve pressure can halt the resorption process and safeguard the affected toothโs integrity.
I recommend that you enroll in the upcoming hands-on course, Mastering Splint Therapy at the Pankey Institute, and gain more expertise in occlusion, appliance therapy, and patient-centered treatment planning. This course will help you manage parafunction and biomechanical stressors in your patients that contribute to conditions like root resorption, and take your restorative care to the next level.
