Internal resorption
Arising from within the root canal — caused by chronic pulpitis. Appears on the radiograph as a radiolucency “inside the tooth”. Treatment: root canal treatment with cleaning of the defect and an MTA seal.
06 — Resorption therapy
Root
resorption in Kiel.
When the tooth root is broken down from the inside or from the outside — usually a slow process that causes no symptoms. With CBCT diagnostics and microscope-guided therapy we halt the breakdown and preserve the tooth.
What is it?
The silent
loss of substance.
Root resorption is the pathological breakdown of dental hard tissue at the root. Specialised cells (clastic cells) dissolve dentine and root cementum — from the inside out of the root canal, or from the outside from the surrounding tissue.
Resorptions usually progress without any symptoms and are found by chance on a radiograph — often during another treatment. That is precisely what makes them insidious: by the time pain appears, the damage has often already advanced.
The treatment depends on the type and location of the resorption. Some can be managed orthogradely (through the root canal), others need surgical access. In every case the rule is: the earlier, the better the chances of keeping the tooth.
Which types?
Three forms
of resorption.
The correct diagnosis is the basis of every treatment. We distinguish three clinically relevant forms:
External cervical resorption (ECR)
From the outside at the neck of the tooth — often after orthodontic treatment or internal bleaching. Frequently visible as a pink discolouration. Treatment: surgical access and an MTA seal, possibly combined with a root canal filling.
External inflammatory resorption
Apical or lateral — after trauma or with chronic apical inflammation. Treatment: prompt root canal filling and treatment of the inflammation, in severe cases an apicoectomy.
Common causes
Why
do they occur?
In many cases a trigger can be identified — sometimes the cause remains unclear (idiopathic).
Dental trauma
A blow or a fall onto the tooth — even when no visible damage remains, resorption can develop years later.
Orthodontics
If teeth are moved too quickly or with too much force, root substance can be broken down — usually at the apex.
Internal bleaching without protection
Older bleaching techniques without a tight cervical seal could trigger external cervical resorption. Today with a protective barrier — risk considerably reduced.
Chronic inflammation
Apical periodontitis persisting over years can trigger external inflammatory resorption.
Periodontal disease
With deep pockets and chronic inflammation, resorption can become established at the neck of the root.
Idiopathic
In a proportion of all resorptions no cause can be identified — here too, treatment is usually possible.
Process
Diagnosis and
treatment.
01
Clinical examination
Inspection, vitality testing, probing. With cervical resorption sometimes visible as a pink discolouration of the neck of the tooth.
02
CBCT diagnostics
3D imaging shows the type, location and extent of the resorption — and with it whether the tooth can be kept. Essential for every resorption.
03
Treatment plan
Depending on the type: orthograde (through the tooth), surgical (access from the outside) or combined. We discuss the options openly.
04
Access & cleaning
Microscopic removal of the resorptive tissue. With internal resorption through the root canal, with ECR through a mucosal flap.
05
MTA seal
Bioceramic materials seal the defect durably and are well tolerated by the body. They support tissue regeneration.
06
Root canal treatment
With internal resorption the root canal filling is part of the treatment. With external resorption only if the pulp is involved.
07
Stable restoration
Core build-up or crown — protection against renewed bacterial penetration.
08
Close follow-up
Resorptions can start again after treatment — radiographic checks after 3, 6 and 12 months.
75–90%
preservation rate
With early diagnosis and targeted treatment — depending on type and stage.
CBCTreq.
3D diagnostics
Without CBCT, resorptions often cannot be assessed correctly.
Early
= better
Early treatment considerably improves the chances of keeping the tooth.
Costs
What does
the treatment cost?
Treating resorption is complex and is generally charged as a private service. The effort involved varies considerably with the type and location.
Guide prices
- Internal resorption (orthograde): approx. €700–1,200
- External cervical resorption (surgical): approx. €900–1,500
- External inflammatory resorption: approx. €600–1,000
- CBCT diagnostics: approx. €100–250
Before treatment begins we provide a transparent written cost estimate.
Common questions
Answers
on resorption.
The questions our patients ask most often — answered directly.
What is root resorption?
A pathological breakdown of dental hard tissue at the root. Specialised cells (clastic cells) dissolve dentine and cementum — either from the inside (internal resorption) or from the outside (external resorption).
Common causes: trauma, orthodontic treatment, internal bleaching without protection, chronic inflammation, idiopathic.
Does resorption hurt?
Usually not. Resorptions progress without symptoms over months to years. Pain only appears once the resorption reaches the pulp or a secondary infection has developed. That is precisely what makes them insidious — they are often found by chance on a radiograph.
How is resorption diagnosed?
Resorptions are usually discovered as an incidental finding on 2D radiographs taken for other reasons. To assess the type, extent, location and treatment options, a CBCT (3D imaging) is almost always required.
Can the tooth be kept?
With early diagnosis and targeted treatment the tooth can be preserved in many cases. The type, extent and timing of the treatment are decisive. With advanced ankylotic replacement resorption (above all after replantation) long-term preservation is often not possible.
How is the resorption stopped?
Under the microscope we remove the resorptive tissue (the active clastic cells) and seal the defect with MTA or a bioceramic material. This interrupts the process — the likelihood of recurrence falls considerably.
Is everything over after the treatment?
In rare cases resorptions can become active again. Therefore: close radiographic follow-up after 3, 6 and 12 months — then annually if the findings are stable.
Do I need a referral?
No. You can book an appointment directly. Please bring recent radiographs with you; that speeds up the diagnosis.
More treatments
Related
procedures.
Resorption treatment is often part of a larger course of treatment.
Diagnostics
CBCT — 3D imaging
Essential for every resorption — precise assessment.
Find out more RepairPerforation repair
When the resorption has already broken through the root wall.
Find out more SurgeryApicoectomy
For apical inflammatory resorption with a large lesion.
Find out more RetreatmentEndodontic retreatment
With internal resorption: often combined with a complete retreatment.
Find out moreBook
Resorption diagnosed?
We can help.
Please bring your radiographs. CBCT diagnostics directly at the practice.