CBL #11: External Root Resorption Repair
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- Опубликовано: 8 июл 2024
- In this video Dr. Allen Ali Nasseh shares a case of external root resorption and his approach at a combined non-surgical / surgical repair of the defect.
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just a wonderful learning case and that euphoric feeling when you save a tooth that was otherwise gone.
Thank you Dr. Ali
Fascinating!
Really good work dr Nasseh. Thank you for the helpful information. Salam ou aleikum :)
thanks alot dear doctor for shearing ur great informations, pleas if u manage apical part by putty why u consider about apical preparation by size 70 and taper 4, why u prepare apical area? for that lare size if u not mechanical tug back?
Sir, did you treat the lesion externally? Some curettage of the tissue usually seen in external resorption?
What dental code would you bill insurance for this procedure?
Beautiful case! Regarding this large ER lesion. Do we get any attachment to the RRM putty? More specifically, if we had an external lesion surpassing the crestal bone, would we generally have a large probing defect?
You do get attachment to the Putty. It turns into Hydroxy appetite and a version of it without any opacifying agent is in the works as a bone graft! :) So, no defect. That's what's remarkable about it.
Real World Endo Awesome thank you!
Can you use this for internal resorption
i dont understand why did you make an apical stop instead of making regular gb filling and how did you manage to push the putty all the way to the apex abd if their is a chance of an overfill . Thank you dr naseh
Good question. Sorry for the late reply. The reason was to create and apical plug so I can fill the whole canal without any gutta percha (Monoblock!) I wanted to be able to drill into it later for the repair without exposing gutta percha and be able to place the putty against the sealer for better bond. So, the plug was a barrier to avoid extrusion of the sealer out of the end of the root and be able to inject and fill the whole canal with sealer after the plug (like the barrier technique in one step apexification I've described before.)
I had teeth braces four fourteen years
Thank you for making this video. It gives me hope for saving my own tooth. I hope after all these years you are still able to respond to comments. I have a tooth (#9) that has similar external root resorption as in the case you’ve documented here. I live in the Atlanta, GA area and I’m trying to find an endodontist that can do this same procedure. I’m having a hard time finding one and I was wondering if you know of any that you can recommend in the Atlanta area? Thank you!
You can see Dr. Rico Short in Atlanta but I’m not sure if he does these surgeries. The main question is surgical access. If it’s on the lip side you may have a chance. Deep between the teeth or on the palate side and the success is poor. A CBCT will decide that. Good luck.
@@AANasseh Thank you so much for your help and information. I really appreciate you taking the time to reply back to me.
Can the cells that cause external resorption in teeth spread to the jaw bone and destroy that bone as well? I have been seeking an answer to this question and can find no mention of it in any of the research papers I have reviewed, nor in any videos I have seen on RUclips. Your response would be much appreciated.
Cells that destroy the root are, in fact, the same cells that naturally destroy the jawbone and other bones called osteoclasts. You see, the bone is in a constant state of turn over, which is ideally a balance between resorption and deposition. Every ten years, your body has a brand new skeleton!!! Most people don’t realize this as it’s occurring slowly and constantly throughout our body.... except our teeth! Our teeth are deposited once and do not turn over! They are formed once and supposed to last us our lifetime as they are protected by a layer that prevents these local osteoclast cells from mistakenly break them down like they do to bone. Resorption has been speculated to occur when this protective layer wears off in an area and bone destroying cells adhere mistakenly to teeth! Problem is that root forming cells are long gone in that area. So, the net effect is root resorption and no apposition! Good question! 👍
@@AANasseh Thanks for the response. So does that mean that tooth root resorption, if left untreated, can lead to jaw bone resorption?
@@NeartTa I don’t hunk you understood the response. The cells that cause bone resorption cause root resorption. So, bone resorption in the he is happening at all time and is not a problem if couples with deposition. The root can not be coupled and is therefore a problem, not bone. Bone is a problem when people have osteoporosis and other problems like that where the rate of resorption exceeds deposition. Hope it makes sense now.
@@AANasseh I understand. I'm neither a physician nor a medical student, so I appreciate you taking the time to explain this in layman's terms. Best of luck with your practice and thank you for seeking to shed light on one of the less well understood subjects of dental health.
Hello Dr. if there was an apical lesion, would you perform an apicectomy additionally to sealing the resorptive lesion even if the sinus tract disappeared just with the orthograde treatment? I have similar case of a lower canine but there's an apical lesion about 8mm diameter. The sinus tract was gone after one week with intracanal dressing. Thanks for sharing.
As long as the sinus tract is gone and you have attachment why do surgery? Just follow up in six months and see if the area has decreased and you can always do surgery later if needed. Cheers.
@@AANasseh Thank you very much Dr.
Hey Dr Ali. Just noticed this was done in 2014. I was just told I have tooth root resorption and still have a few months of orthodontic treatment left. Are there any new methods for re-growing tooth root or any modalities or suggestions you may have? Thank you, Dr Ali!
unfortunately nothing new. It's still the same deal. You repair the resorptive lesion if it's surgically accessible or watch it until it becomes infected and remove and replace if it's not surgically accessible. good luck!
Hello sir. Love all your videos, although why do most of your video's end half way??
These videos should direct you to the full version on our website. These are designed to promote our website. Most videos that come out at full and then after a while are edited in half with link to see the full on the website.
Hey sir.. I am from pakistan.. I have my 2nd orthodontic treatment.. I have protruded teeth and obviously for this they have to extract my 1st premolars to make space.. But i have root resorption in some of my teeth.. I am worried about it,,, whether i should go for extraction or continue my braces treatment without extraction?
Don't extract just because of resorption unless you have symptoms or infection. Many of these resorptive lesions can proceed for years without a problem. You only extract if you have symptoms or infection. Not just because you see resorption!
Will this stop completely further root resorption?
Only if all the resorptive tissue has been removed or made inactive.
I hve tooth resorption due to braces. But teeth is still not aligned. Can i go for braces or invisaligner after tooth tesorption gets stable. Also want to knw how rapid is tooth resorption. I had braces for 3.5 yrs and now its removed.
I also have had braces since I was 9 and got them off when I was 15 and have also had external root resorption. I am now 19 and my tooth became really dark I’m not sure what to do since whitening it will make the tooth weaker and it’s my front tooth.
My orthodontist said i have tooth resporption when they placed my braces on they will monitor of the tooth resorption continues then they will have to remove the braces praying my tooth resorption doesnt interfere with the orthodontist plan
Hey. Just saw your comment. In a similar situation. We’re you able to complete ortho treatment?
@@VAHZGEN i am also in the same situation
Hell no thank you five years of verses from 13 to 18, 57 years old now... Hell no no my bookshelves for me had one and no thank you I think it will destroy the truth even more and what’s the play going to have to get a hold anyways eventually so you gonna waste a lot of money working out for the front tooth and I’ll think so he can fix it with them bone grafting they’ll be awesome but otherwise nope
That made no sense. BTW, the woman who had this procedure still has the tooth and the procedure was done in 2009.