Root resorption is a process in which the body begins breaking down and removing portions of a tooth or its root structure.

This process is normal when baby teeth are being replaced by permanent teeth, but it is not considered normal when it affects an adult tooth. Depending on the type and location, resorption can involve the inside of the tooth, the outer surface of the root, or both.

Because root resorption can progress without obvious symptoms, early diagnosis and careful evaluation are important.

Root resorption is generally classified based on where the process begins.

Internal resorption starts within the root canal space and causes loss of tooth structure from the inside outward. It is often associated with inflammation of the dental pulp.

External resorption begins on the outside surface of the root. There are several forms of external resorption, and they can differ significantly in cause, location, progression, and treatment.

Determining whether resorption is internal or external is important because the treatment approach and prognosis may be very different.

The exact cause is not always identifiable, but root resorption may be associated with:

• Dental trauma

• Inflammation or infection

• Orthodontic tooth movement

• Previous dental procedures

• Pressure from impacted teeth or other nearby structures

• Certain developmental or idiopathic processes

In some patients, no clear cause can be determined.

The type, location, and extent of the resorption are often more important for treatment planning than identifying a single underlying cause.

Root resorption frequently causes no symptoms in its early stages and may be discovered incidentally during routine dental imaging.

When symptoms are present, they can include:

• Tooth discoloration

• Sensitivity to hot or cold

• Tenderness when biting or chewing

• Swelling or tenderness in the gums

• A change in the appearance of the tooth or surrounding gum tissue

• Symptoms related to pulpal inflammation or infection

Because these symptoms can occur with many other dental conditions, imaging and clinical testing are needed to establish the diagnosis.

Diagnosis usually involves a combination of clinical examination, pulpal testing, periodontal evaluation, and dental imaging.

Traditional two-dimensional X-rays can identify many resorptive defects, but the true size, location, and extent may be difficult to determine from a single image.

3D CBCT imaging provides a more detailed view of the defect and its relationship to the root canal system and surrounding structures. This information can be especially valuable when deciding whether the tooth can be treated and which approach is most appropriate.

Treatment depends on the type, location, extent, and activity of the resorptive process.

For some forms of internal resorption, root canal therapy may be used to remove the inflamed pulpal tissue and help stop progression of the resorption.

External resorption may require a different approach depending on where the defect is located and whether it can be accessed. Treatment can involve root canal therapy, repair of the resorptive defect, or in selected situations endodontic microsurgery.

Some small or inactive areas may simply require monitoring, while teeth with extensive loss of tooth structure may not be predictably treatable.

Because resorption can vary significantly from one tooth to another, treatment recommendations are made only after a complete evaluation.

Many teeth affected by root resorption can be preserved, particularly when the condition is diagnosed early and the defect is limited or accessible for treatment.

The prognosis depends on factors such as:

• The type of resorption

• The size and location of the defect

• How much healthy tooth structure remains

• Whether the dental pulp is involved

• Whether the defect can be adequately cleaned and repaired

• The condition of the surrounding bone and supporting tissues

In more advanced cases, resorption may weaken the tooth or extend into areas that cannot be predictably treated.

Our goal is to determine whether treatment offers a reasonable long-term prognosis before recommending that the tooth be preserved.