Athina M Mavridou1, Esther Hauben2, Martine Wevers3, Evert Schepers4, Lars Bergmans4, Paul Lambrechts4. 1. Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven and University Hospitals Leuven, Leuven, Belgium; Private Practice, Endo Rotterdam, Rotterdam, The Netherlands. Electronic address: athimavridou@gmail.com. 2. Department of Imaging and Pathology, KU Leuven and University Hospitals Leuven, Leuven, Belgium. 3. Department of Materials Engineering (MTM), KU Leuven, Leuven, Belgium. 4. Department of Oral Health Sciences, BIOMAT Research Cluster, KU Leuven and University Hospitals Leuven, Leuven, Belgium.
Abstract
INTRODUCTION: The aim of this study was to investigate the 3-dimensional (3D) structure and the cellular and tissue characteristics of external cervical resorption (ECR) in vital teeth and to understand the phenomenon of ECR by combining histomorphological and radiographic findings. METHODS: Twenty-seven cases of vital permanent teeth displaying ECR were investigated. ECR diagnosis was based on clinical and radiographic examination with cone-beam computed tomographic imaging. The extracted teeth were further analyzed by using nanofocus computed tomographic imaging, hard tissue histology, and scanning electron microscopy. RESULTS: All examined teeth showed some common characteristics. Based on the clinical and experimental findings, a 3-stage mechanism of ECR was proposed. At the first stage (ie, the initiation stage), ECR was initiated at the cementum below the gingival epithelial attachment. At the second stage (ie, the resorption stage), the resorption invaded the tooth structure 3-dimensionally toward the pulp space. However, it did not penetrate the pulp space because of the presence of a pericanalar resorption-resistant sheet. This layer was observed to consist of predentin, dentin, and occasionally reparative mineralized (bonelike) tissue, having a fluctuating thickness averaging 210 μm. At the last advanced stage (ie, the repair stage), repair took place by an ingrowth and apposition of bonelike tissue into the resorption cavity. During the reparative stage, repair and remodeling phenomena evolve simultaneously, whereas both resorption and reparative stages progress in parallel at different areas of the tooth. CONCLUSIONS: ECR is a dynamic and complex condition that involves periodontal and endodontic tissues. Using clinical, histologic, radiographic, and scanning microscopic analysis, a better understanding of the evolution of ECR is possible. Based on the experimental findings, a 3-stage mechanism for the initiation and growth of ECR is proposed.
INTRODUCTION: The aim of this study was to investigate the 3-dimensional (3D) structure and the cellular and tissue characteristics of external cervical resorption (ECR) in vital teeth and to understand the phenomenon of ECR by combining histomorphological and radiographic findings. METHODS: Twenty-seven cases of vital permanent teeth displaying ECR were investigated. ECR diagnosis was based on clinical and radiographic examination with cone-beam computed tomographic imaging. The extracted teeth were further analyzed by using nanofocus computed tomographic imaging, hard tissue histology, and scanning electron microscopy. RESULTS: All examined teeth showed some common characteristics. Based on the clinical and experimental findings, a 3-stage mechanism of ECR was proposed. At the first stage (ie, the initiation stage), ECR was initiated at the cementum below the gingival epithelial attachment. At the second stage (ie, the resorption stage), the resorption invaded the tooth structure 3-dimensionally toward the pulp space. However, it did not penetrate the pulp space because of the presence of a pericanalar resorption-resistant sheet. This layer was observed to consist of predentin, dentin, and occasionally reparative mineralized (bonelike) tissue, having a fluctuating thickness averaging 210 μm. At the last advanced stage (ie, the repair stage), repair took place by an ingrowth and apposition of bonelike tissue into the resorption cavity. During the reparative stage, repair and remodeling phenomena evolve simultaneously, whereas both resorption and reparative stages progress in parallel at different areas of the tooth. CONCLUSIONS: ECR is a dynamic and complex condition that involves periodontal and endodontic tissues. Using clinical, histologic, radiographic, and scanning microscopic analysis, a better understanding of the evolution of ECR is possible. Based on the experimental findings, a 3-stage mechanism for the initiation and growth of ECR is proposed.
Authors: Katarína Mikušková; Peter Vaňuga; Katarína Adamicová; Dagmar Statelová; Mária Janíčková; Igor Malachovský; Tomáš Siebert Journal: BMC Oral Health Date: 2022-04-15 Impact factor: 3.747
Authors: Emily Y Chu; Janina Golob Deeb; Brian L Foster; Evlambia Hajishengallis; Martha J Somerman; Vivek Thumbigere-Math Journal: Front Dent Med Date: 2021-03-26