External resorption is when the body attacks and destroys the root of a tooth, usually caused by trauma or infection. It differs from internal resorption and almost always results in tooth extraction. Ankylosis can occur, causing more serious dental problems. Treatment involves tooth removal and implant placement.
External resorption occurs when the root surface of a tooth becomes inflamed and the body attacks the root, causing it to be destroyed or dissolved. There are two types of resorption: internal and external. External resorption differs from internal resorption in that tooth destruction begins on the outer surface of the tooth, also known as the cementum, and then travels through the tooth tissue to the root. This type of resorption is usually much more severe and almost always results in tooth extraction.
The cause of external resorption is sometimes unclear, but there are many situations that can cause a tooth root to dissolve. Pressure from another tooth or orthodontic materials, for example, can cause trauma to the outside of the tooth, which is sometimes seen in children who have impacted wisdom teeth that are putting pressure on an emerging tooth. Bacteria that cause infection or inflammation can also cause the body to attack and destroy the tooth. Additionally, trauma to the tooth from a hard blow can result in this condition: the body attempts to dissolve the broken parts of the tooth, which can end in complete resorption of the root.
Once trauma has occurred to the tooth, osteoclasts, a type of cell that destroys bone tissue, attach themselves to the root surface and begin to dissolve the outer root layer of the tooth. This process continues all the way to the inner root of the tooth, destroying blood vessels and nerve tissue and causing the crown of the tooth to become loose and unstable. Tooth resorption occurs if the entire tooth, including the bone, ligament, and crown, is affected.
Sometimes, the space left by dissolved root tissue will be replaced by bone. The bone attaches itself to the tooth in a process called ankylosis. However, the bone will begin to turn other surrounding tooth tissue into bone as well, which can cause even more serious dental problems.
A tooth affected by external resorption must almost always be removed because the dissolution process can also extend to other surrounding teeth; a tooth with internal resorption can however be saved through root canal treatment. Once the tooth is removed, an implant will be placed. A person with symptoms of external resorption should contact a dentist immediately to learn more about external resorption and to determine a course of treatment.
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