31/07/2025
Internal root resorption is a rare but clinically significant condition characterized by the progressive loss of intraradicular dentin due to clastic activity originating within the pulp space. It usually results from chronic pulpal inflammation—often following trauma, caries, or extensive restorative procedures. Radiographically, it presents as a well-defined, round to oval radiolucency centered within the root canal, typically symmetrical and continuous with the canal walls. Unlike external resorption, the outer root surface remains intact in early stages.
The pathogenesis involves activation of odontoclasts in response to inflamed vital pulp tissue, particularly when necrosis is partial and the coronal portion remains infected while the apical pulp stays vital. This creates a permissive environment for resorptive activity, often progressing silently unless it reaches the external surface or perforates the root.
Clinically, internal resorption is usually asymptomatic and diagnosed incidentally on radiographs, but it may present with a "pink spot" in advanced coronal cases due to granulation tissue. Early diagnosis is critical. Once identified, immediate endodontic therapy is indicated to remove the vital inflamed pulp and arrest further destruction. Thermoplasticized obturation techniques are often required due to the irregular canal shape.
Internal root resorption is irreversible, but its progression can be completely halted with timely and appropriate intervention. Advanced or perforated cases may require surgical management or extraction, emphasizing the importance of regular radiographic follow-up in high-risk teeth.