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Examination of external apical root resorption with scanning electron microscopy
L A Malueg1, L R Wilcox, W Johnson
1Department of Endodontics, University of Iowa College of Dentistry, Iowa City, USA.
Summary
External apical root resorption is often hidden until advanced. Pulp necrosis with apical lesions indicates a higher likelihood of resorption, impacting endodontic treatment.
Area of Science:
- Endodontics
- Dental Histopathology
Background:
- External apical root resorption (EARR) is a pathological process affecting the root apex.
- EARR may not be radiographically detectable until significantly advanced, potentially leading to procedural errors in endodontic treatment.
Purpose of the Study:
- To investigate the incidence and appearance of EARR using scanning electron microscopy (SEM).
- To compare EARR in teeth with diverse pulpal and periapical conditions.
Main Methods:
- SEM examination of 46 root sections from 40 teeth, horizontally sectioned 6 mm from the apex.
- Independent scoring of photomicrographs by two blinded examiners to categorize resorption (none, partial, complete) and note funneling.
- Statistical analysis using Kruskal Wallis and Duncan's multiple range tests.
Main Results:
- Significant differences in EARR incidence were observed across diagnostic groups.
- Teeth with irreversible pulpitis and normal periapices exhibited the least resorption.
- Teeth with necrotic pulps and radiographic apical lesions demonstrated significantly more resorption compared to vital pulps or those without lesions.
Conclusions:
- Pulp necrosis combined with radiolucent apical pathosis is strongly associated with a higher prevalence of EARR.
- SEM provides detailed insights into EARR morphology and incidence in relation to pulpal and periapical status.
