Interventions for the management of external root resorption

Review question

This review has been conducted to assess different interventions for managing the reabsorption of the tooth root.

Background

External root resorption is when the body’s own immune system dissolves the tooth root structure. It can occur following tooth infection, orthodontic treatments or in the presence of unerupted teeth in the jaw. Although this condition does not usually produce symptoms, external root resorption may result in movement of the tooth and, if not diagnosed and treated at an early stage, might eventually result in the tooth falling out. Despite this condition being quite common, treatment is generally on a case-by-case basis and there is a lack of evidence regarding the best treatments.

Study characteristics

Authors from the Cochrane Oral Health Group carried out this review of existing studies, and the evidence is current up to 14 October 2015. There were no studies found that met the inclusion criteria for this review.

Key results and quality of the evidence

This review revealed that there is no evidence for the effectiveness of available treatments and there is therefore a need for further research to help clinicians and patients to make informed choices about treatment options.

Authors' conclusions: 

We were unable to identify any reports of randomised controlled trials regarding the efficacy of different interventions for the management of external root resorption. In view of the lack of reliable evidence on this topic, clinicians must decide on the most appropriate means of managing this condition according to their clinical experience with regard to patient-related factors. There is a need for well designed and conducted clinical trials on this topic, which conform to the CONSORT statement (www.consort-statement.org/).

Read the full abstract...
Background: 

External root resorption is a pathological process, which tends to occur following a wide range of mechanical or chemical stimuli such as infection, pressure, trauma or orthodontic tooth movement. Although it is predominantly detected by radiography, in some cases root resorption may be identified by clinical symptoms such as pain, swelling and mobility of the tooth. Treatment alternatives are case-dependent and aim to address the cause of the resorption and aid the regeneration of the resorptive lesion.

Objectives: 

To evaluate the effectiveness of any interventions that can be used in the management of external root resorption in permanent teeth.

Search strategy: 

The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 14 October 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 9), MEDLINE via OVID (1946 to 14 October 2015) and EMBASE via OVID (1980 to 14 October 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.

Selection criteria: 

We included randomised controlled trials of permanent teeth with any type of external root resorption, which has been confirmed by clinical and radiological examination, comparing one type of intervention (root canal medications and canal filling, splinting or extraction of teeth or the surgical removal of any relevant pathology) with another, or with placebo or no treatment.

Data collection and analysis: 

Two review authors screened search records independently. Full papers were obtained for potentially relevant trials. If data had been extracted, the statistical guidelines set out in the Cochrane Handbook would have been followed.

Main results: 

No randomised controlled trials that met the inclusion criteria were identified. However, we identified one ongoing study that is potentially relevant to this review and will be assessed when it is published.

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