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Old 08-22-2011, 10:14 AM   #1
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guido15 HB User
External/internal resorption

Hello, first time poster. Went to see my dentist today as a six month checkup to a root canal on tooth #21. I've had sensitivity ever since the root canal. Nothing major. Well the dentist said I had an external/internal resorption and had to have the tooth pulled! I just spent over $2500 for a filling which turned into a root canal and crown and now I got to have it pulled? Anyone out there who has had something like this? I am going to get a second opinion for sure. But I was wondering if a botched root canal or a traumatic crown procedure could have been the reason behind this resorption. Any comments out there? Thanks in advance.

 
Old 08-23-2011, 04:54 PM   #2
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Elizabetho HB UserElizabetho HB UserElizabetho HB UserElizabetho HB User
Re: External/internal resorption

hi guido 15, well, this is a bit unusual. the causes for internal resportion are not well understood, and you don't run into it that often. external resporption is a little better understood, and sometimes results from aggressive orthodontic treatment.

if the internal resorption is too big, there may not be much of the root's walls left and filling the canal of the tooth may wind up cracking the tooth. that is the worst case. if the internal resportion is not too big, the tooth can be cleaned and treated as if it were a normal root canal case. if resorption occurred both inside the canal ("internal") *and* on the surface of the root of the tooth ("external"), i'd want to know if both of the resorptions appear at the same spot on the root. my very best guess would be there might be a small canal (so small as to not show on a regular xray) that exists and that allows the destructive resorptive elements the body produces to pass from either the pulp side to the root side or vice versa, from the root side to the pulp side. it may well be that this all developed during these last six months (which can be verified by comparing pre-treatment xrays with today's xrays).

if the pretreatment films do not show any evidence of external resorption, and today's xrays show a lot of damage, you may need to have the tooth extracted. the resortive process is very destructive and it can destroy the tooth's ligament, bone, and root surface. it is, basically, an inflammatory process and it destroys tissue in its wake, but for no apparent reason (other than ortho as i mentioned, which actually provokes an inflammatory response in that you are deliberately destoying ligaments and the body then rebuilds them in their new positions.) the thing about the kind of resportion you are describing is that it is apparently spontaneous. if external resorption is extensive, you will probably be advised to extract it, so as to stop (and remove) the process. (the only good thing about resorption is that it is generally localiized and does not spread thoughout the jaw, but it does damage whatever tissue it is in contact with.) to arrest it (by extraction). if the resortion appears to be confined to the internal canal and your pain subsides, you might be able to adopt a wait and see approach and have it checked every few months. good luck with this --i'm sorry i don't have better news than this. maybe you could let us know how this goes?

 
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Old 08-24-2011, 01:15 PM   #3
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Re: External/internal resorption

Thank You for the response. It appears to be internal, but you can't really tell because the radio lucency could be from the back of the tooth. The radio lucency was not there prior to treatment. So this reared it's head within the 6 months after the root canal. It is rather advanced I'm afraid. Not much left of between the resorption damage and edge of tooth. I am going to see my periodontist next week and I trust him completely. But, it looks like I will have to pull the tooth. I will let you know. Mike

 
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