CASE STUDY: Resorption or Decay?
Resorption is an uncommon and troublesome dental condition in which the body’s own cells eat away and dissolve tooth structure. It can at times be confused as decay on a dental x-ray. It also can be very aggressive and quick to destroy healthy tooth structure.
See the 2 dimensional x-ray here.
Here you see two teeth (premolars) both with resorption not decay. The distal of #20 has been restored with composite due to easy access from the missing tooth. However, the outcome is not as favorable on tooth #21. See the cross section view of tooth #20 and #21 in a 3Dcone beam scan.
Now you begin to visualize that more of the tooth has been effected and makes the prognosis poor.
The first question was resorption or decay?
The second question is how would you treatment plan this area now?
- Fill tooth #21.
- Crown tooth #21
- Root Canal and Crown #21
- Extract #21 and place Implant
- Extract #21 and #20
- Extract #21 and 20 and place Implants in site #19 and #21 and restore with an Implant Supported 3 unit Bridge
Once again, a great reason to begin to utilize the high-tech imaging method of 3D cone beam computed tomography. It can help make treatment planning in advance more accurate.