Volumetric Analysis of Resorption Types on CBCT

Three-dimensional Volumetric/ Linear Analysis and Axial Classification of Root Resorptions Using Cone Beam Computed Tomography: A Retrospective Study

More accurate management of resorption can be achieved thanks to the three-dimensions volumetric and linear analysis, and the axial classification presented in this study.

Study Overview

• Status: Completed
• Conditions: Endodontic Disease; Tooth Resorption

Detailed Description

The aim of this study was to investigate the volumetric and linear analysis, and to present the axial classification of root resorptions using cone beam computed tomography (CBCT).

A total of 43 teeth of external cervical resorption (ECR) (n=27), external replacement resorption (ERR) (n=4) and internal root resorption (IRR) (n=12) were identified from 34 patients. The volume of resorption and total tooth, the widest lengths of these resorptions, and the amount of thinnest dentin thickness around them were measured and compared according to age and sex. Additionally, the eight regional axial classification was performed and the percentages in these regions were evaluated. Significance was set at p=0.05 for statistical analysis.

More accurate management of resorption can be achieved thanks to the three-dimensions volumetric and linear analysis, and the axial classification presented in this study.

• Study Type: Observational
• Enrollment (Actual): 43

Contacts and Locations

Study Locations

• Turkey
  • Rize, Turkey, 53100
    • Recep Tayyip Erdogan University Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 71 years (ADULT, OLDER_ADULT, CHILD)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Cases of resorption that had CBCT images were included in the study. Radiographic features of resorption were defined in the images of 34 patients in accordance with these criteria. A total of 43 teeth with ECR (n=27), ERR (n=4), and IRR (n=12) were identified from 34 patients.

Description

Inclusion Criteria:

• Cases of resorption that had CBCT images

Exclusion Criteria:

• those presenting pathologic lesions, congenital/developmental anomalies or teeth with root canal filling
• those whose CBCT scans failed to present satisfactory quality.
• Additionally, SR, TAP, and EIR cases were excluded because their true dimensions could not be completely determined before resorption.

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort
Group 1. Internal root resorption (IRR); Internal root resorption is the progressive destruction of intraradicular dentin and dentinal tubules along the middle and apical thirds of the canal walls as a result of clastic activities. It is seen as a radiolucent area around the pulpal cavity, usually of incisors and mandibular molars. The various etiological factors suggested for internal root resorption include traumatic injury; infection and orthodontic treatment.
Group 2. external cervical resorption (ECR); Cementum is considered to protect the underlying root dentin from being resorbed. It is broadly accepted that damage to or deficiency of this protective cementum layer below the epithelial attachment exposes the root surface to osteoclasts, which then resorb the dentin. Clinical sign; Located in cervical region of tooth Pink spot might be noted by patient/dentist Tooth usually responds positively to vitality tests unless there is pulpal involvement (in very advanced cases) Spontaneous and profuse bleeding on probing Sharp, thinned out edges around the resorptive cavity
Grup 3. external replacement resorption (ERR); external replacement resorption also known as trauma-induced resorption - and this resorption may occur in teeth that also have external inflammatory resorption. This review will not discuss external replacement resorption in detail but it will be mentioned where relevant as both types of resorption may occur in some cases. This is because replacement resorption is a consequence of the same injuries that typically cause external inflammatory resorption - such as intrusion and avulsion where there is significant damage to the external root surface during the injury, as well as sometimes during the repositioning/ replantation of the tooth.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Volume of total tooth and resorbed area	The total volume and the resorption volume were measured with used 3D semi-automatic segmentation program (ITK-SNAP 2.4)	for three months from the beginning of the study
Measurement widest mesio-distal length, bucco-lingual length and corono-apical length of the resorbed lesion	Linear measurement were measured with used Planmeca ProMax 3D Classic (Planmeca Promax 3D; Planmeca Oy; Helsinki, Finland)	for three months from the beginning of the study
Linear measurements for thinnest dentin (buccal, distal, mesial and lingual/ palatinal) and resorbed area (mesio-distal length and bucco-lingual length) were made on axial sections	Linear measurement were measured with used Planmeca ProMax 3D Classic (Planmeca Promax 3D; Planmeca Oy; Helsinki, Finland)	for three months from the beginning of the study
The corono-apical length was measured on sagittal sections where the tooth axis was perpendicular to the ground plane.	Linear measurement were measured with used Planmeca ProMax 3D Classic (Planmeca Promax 3D; Planmeca Oy; Helsinki, Finland)	for three months from the beginning of the study
the axial section of the tooth was divided into eight parts and regional settlement classification was performed	Segmentation were made with used Planmeca ProMax 3D Classic (Planmeca Promax 3D; Planmeca Oy; Helsinki, Finland)	for three months from the beginning of the study

Collaborators and Investigators

• Sponsor: Recep Tayyip Erdogan University Training and Research Hospital
• Investigators: Study Chair: Dilara Nil Günaçar, Recep Tayyip Erdogan University Training and Research Hospital

Publications and helpful links

General Publications

• Heithersay GS. Clinical, radiologic, and histopathologic features of invasive cervical resorption. Quintessence Int. 1999 Jan;30(1):27-37.
• Patel S, Dawood A, Wilson R, Horner K, Mannocci F. The detection and management of root resorption lesions using intraoral radiography and cone beam computed tomography - an in vivo investigation. Int Endod J. 2009 Sep;42(9):831-8. doi: 10.1111/j.1365-2591.2009.01592.x. Epub 2009 Jul 14.

Study record dates

Study Major Dates

• Study Start (ACTUAL): June 22, 2020
• Primary Completion (ACTUAL): August 10, 2020
• Study Completion (ACTUAL): October 21, 2020

Study Registration Dates

• First Submitted: October 30, 2020
• First Submitted That Met QC Criteria: October 30, 2020
• First Posted (ACTUAL): November 5, 2020

Study Record Updates

• Last Update Posted (ACTUAL): November 5, 2020
• Last Update Submitted That Met QC Criteria: October 30, 2020
• Last Verified: October 1, 2020

More Information

Terms related to this study

• Keywords: endodontics; cone beam computed tomography; tooth Resorption
• Additional Relevant MeSH Terms: Stomatognathic Diseases; Tooth Diseases; Dental Pulp Diseases; Tooth Resorption
• Other Study ID Numbers: 2020/98

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No