Can a Reabsorbed Tooth Be Saved?
Internal tooth resorption is a silent phenomenon, often overlooked, but can have serious consequences on dental health. It manifests itself by the progressive destruction of dental tissue from the inside out. But what causes this problem? How can it be diagnosed in time? And what are the best treatment options available? In this article, we will explore these essential questions.
Each tooth is a complex organ, made up of a solid external structure, enamel, and an internal structure, dentin, which surrounds the central pulp. Internal dental resorption involves a degradation of these internal structures, endangering the health of the tooth. While the prevalence of this pathology remains relatively low, its clinical importance should not be underestimated.
The fundamental question is: why is this happening? Several factors can predispose a tooth to internal resorption. Among the most common are trauma, such as shock or injury, as well as certain infections that can affect the dental pulp. At a molecular and cellular level, this process is complex and may involve an uncontrolled inflammatory response, leading to progressive destruction of dental tissue.
One of the main challenges of internal tooth resorption is that it can remain asymptomatic for a long time. Often, the first clinical signs are subtle and can be overlooked. However, with the adoption of modern imaging techniques, such as cone beam volume computed tomography (CBTCT), it is now possible to detect these changes at an early stage, allowing rapid intervention.
Treatment
Internal tooth resorption, an insidious and often asymptomatic pathology, requires careful intervention to preserve the structure and function of the tooth and avoid extraction. Technological advances and recent medical research have diversified treatment options, allowing more tailored care for each specific case. Let's look at these approaches in detail.
Conventional approaches
Endodontic Therapy: The most commonly used technique to treat internal tooth resorption is endodontic therapy, commonly called root canal treatment. The procedure involves removing the affected pulp tissue, cleaning the root canal, and then filling it with a biocompatible filling material to prevent further infection. Once the canal is filled, the tooth is usually restored with a crown to strengthen its structure.
Apical Surgery: In cases where resorption is not achievable through traditional root canal treatment or where the condition persists after endodontic treatment, apical surgery may be considered. This surgical procedure treats resorption at the apex of the tooth, removing the affected portion of the root and sealing the root end.
Innovative approaches
Gene therapy: Emerging in the medical world, gene therapy offers hope for treating various conditions, including tooth resorption. By modifying or replacing defective genes at the origin of the pathology, it is theoretically possible to correct the anomaly at the source. Although this approach is still in its infancy in dentistry, it promises revolutionary advances.
Use of Stem Cells: Stem cells possess the unique potential to differentiate into various cell types, providing the opportunity to regenerate dental tissues affected by resorption. Preliminary studies suggest that stem cells could be used to revitalize a tooth after internal resorption, restoring not only its structure, but also its function.
Internal tooth resorption, although less common than other dental conditions, deserves special attention from dental professionals and patients. Early diagnosis, coupled with appropriate interventions, is essential to preserve the health and function of affected teeth. Additionally, continued innovation in diagnosis and treatment highlights the importance of research in this area to ensure the best possible care.