Root Resorption (Internal & External)

• •Most cases produce no symptoms at all in the early stages.
• •A pink discoloration of the crown of the tooth (the underlying resorbing tissue showing through thinning enamel) — a classic late sign.
• •Mild sensitivity or vague discomfort.
• •Loosening of the tooth in advanced cases.
• •An incidental finding on a routine periapical X-ray during a checkup.

Past dental trauma is the leading cause of external resorption, sometimes years after the original injury. Internal resorption is associated with chronic pulp inflammation. Less commonly, orthodontic forces, internal bleaching, and viral or genetic factors play a role.

Two-dimensional X-rays show resorption only when it is well advanced. Three-dimensional CBCT imaging is the standard of care and is essential for distinguishing internal from external resorption, mapping how much root structure remains, and deciding whether the tooth is salvageable. We scan every resorption case on the J. Morita Veraview X800 — widely regarded as the leading dental CBCT for endodontics — in its high-resolution Endo Mode (80 µm voxel, 40 × 40 mm limited field of view), the small-volume protocol the AAE/AAOMR Joint Position Statement on the Use of CBCT in Endodontics (2015) and the AAE position statement on resorption both recommend.

Internal resorption is usually treated with prompt root canal therapy, which removes the resorbing tissue and seals the void. External resorption can sometimes be repaired surgically when the defect is accessible. Aggressive forms — particularly invasive cervical resorption that has hollowed out a large portion of the root — may not be restorable and require extraction.