Consolaro Alberto, Bittencourt Graziella
Full professor at Faculdade de Odontologia de Bauru, Universidade de São Paulo (FOB-USP) and in the Post-Graduation program at Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo (FORP-USP).
Professor of Endodontics at ABO-ES and at ESFA-ES.
Dental Press J Orthod. 2016 Nov-Dec;21(6):20-25. doi: 10.1590/2177-6709.21.6.020-025.oin.
This paper aims at exposing the foundations or reasons why, in cases of external tooth resorption, including those of orthodontic origin, one should not perform a root canal to treat it. That should be done only to teeth with contamination or pulp necrosis, to remove the periapical inflammation induced by microbial products. When facing cases of external tooth resorption, one's conduct must always respect the following sequence of steps: first of all, identifying the cause accurately; then, planning the therapeutic approach and, finally, adopting the conducts in a very well-founded way. The situations in which endodontic treatment is recommended for tooth resorptions are those when there are: a) pulp necrosis with microbial contamination, b) aseptic pulp necrosis, c) developing calcific metamorphosis of the pulp and d) diagnosis of internal resorption. It is not possible, through the pulp, to control the resorption process that is taking place in the external part, after all, the causes are acting in the periodontal ligament. There is no evidence that justifies applying endodontic treatment, by means of root canal, to control external resorption processes, when the pulp shows vitality.
本文旨在揭示在包括正畸源性外吸收病例中，为何不应通过根管治疗来处理外吸收的根本原因。根管治疗仅适用于受污染或牙髓坏死的牙齿，以消除微生物产物引起的根尖周炎症。面对外吸收病例时，治疗行为必须始终遵循以下步骤顺序：首先，准确识别病因；其次，规划治疗方法；最后，以充分合理的方式采取行动。对于牙齿吸收推荐进行根管治疗的情况包括：a）伴有微生物污染的牙髓坏死，b）无菌性牙髓坏死，c）牙髓发生钙化性变形，以及d）诊断为内吸收。毕竟，外吸收的病因作用于牙周膜，通过牙髓无法控制外部正在发生的吸收过程。当牙髓显示活力时，没有证据证明通过根管进行根管治疗以控制外吸收过程是合理的。
