Introduction
Internal root resorption (IRR) is a pathological condition involving the progressive loss of dentin within the root canal space due to the activity of clastic cells, typically triggered by chronic pulpal inflammation, trauma, or certain dental treatments. Unlike physiological resorption seen in primary teeth, IRR in permanent teeth is abnormal and often asymptomatic, making early diagnosis challenging. IRR initiates when the protective layers (odontoblasts and predentin are disrupted ) , exposing mineralized dentin to odontoclasts. These resorptive cells , activated by inflammatory mediators like RANKL, begin resorbing the internal canal walls.
IRR can be classified as internal inflammatory resorption ,internal replacement resorption and internal surface resorption .
Clinically , IRR may go unnoticed until detected radiographically. However traditional radiographs can miss early lesions, whereas CBCT offers precise three-dimensional evaluation, especially in complex or perforated cases. Histologically, resorptive areas may show granulation tissue or bone-like deposits depending on the type. Management focuses on eliminating the pulp tissue and sealing the resorptive defect using advanced techniques such as warm gutta-percha, bioceramic sealers , or regenerative protocols when perforation is present.
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