Management of Internal Root Resorption: A Review

Internal root resorption (IRR) is a particular category of pulp disease considered as the loss of dentine as a result of the action of clastic cells stimulated by pulpal inflammation. This review article explains the etiology, the prevalence of internal root resorption, and, in addition to the clinical data, the contribution of the 3D imaging (cone beam computed tomography) to the diagnosis, the clinical decision, and the therapeutic management of internal root resorption. The authors reviewed the different therapeutic possibilities including the orthograde or retrograde fillings of the root canal resorption areas. Root canal treatment stays the treatment of choice of internal root resorption as it eliminates the granulation tissue and blood supply of the clastic cells. The authors describe with different clinical cases the modern endodontic techniques including optical aids, ultrasonic enhancement of chemical debridement, and the usage of alternative materials like calcium silicate combined with thermoplastic filling (warm gutta-percha). In these conditions, the prognosis of the conservative management of internal resorptions, even if root walls are perforated, is good. Mineral trioxide aggregate is being progressively used as a root canal filling material, preferably in cases of perforation.