eugenol cement may be preferred to gutta percha in some cases.
Where resorption is progressive then consideration should be given to
autotransplantation of either an upper second premolar or lower first or second
premolar if any of these teeth were to be removed as part of an orthodontic treatment
plan. If autotransplantation is completed while the root of the premolar is about two-
thirds formed then there is a good chance of revascularisation and further root growth
(760HFig. 12.48 (a and b)). If the autotransplanted tooth has a mature apex then
revasculariztaion is unlikely and the tooth should be exptirpated at splint removal and
the canal dressed with antibiotic/steroid (Ledermix/Lederle) initially, then non-setting
calcium hydroxide. The tooth can be obturated with gutta percha when there is no
evidence of progressive resorption.
Key Points
Pathological root resorption
- inflammatory: external (including cervical)and internal;
- inflammatory may arrest if cause is removed;
- replacement resorption is not amenable to treatment;
- maintain a resorbing tooth for as long as possible. It is the best space maintainer!
761H
Fig. 12.40 External inflammatory
resorption.