Generalized cervical root resorption associated with periodontal disease

Background and description of case: The etiology and pathogenesis of genera lized cervical root resorptions is not well understood. In the present repo rt, a case of severe cervical root resorption involving 24 anterior and pos terior teeth is presented. The lesions developed within a period of 2 years after the patient had changed to an acid-enriched diet. They extended far into the coronal dentin and were associated with gingival inflammation and crestal bone resorption. However, no generalized clinical attachment loss h ad occurred. Culturing of subgingival plaque revealed the presence of sever al putative periodontal pathogens among which Actinobacillus actinomycetemc omitans and Porphyromonas gingivalis. Treatment consisted of mechanical deb ridement supported by systemic antibiotics (amoxycillin plus metronidazole) and dietary advice, Results: Within 1 year after the onset of treatment, all resorptive lesions had repaired by ingrowth of a radio-opaque mineralized tissue. The crestal areas showed radiological evidence of bone repair. 3 years after the onset of therapy, one premolar was extracted and examined histologically. ft app eared that irregularly-shaped masses of woven bone-like tissue had invaded into the domain of the resorbed coronal dentin and were bordered by thin la yers of acellular cementum. Conclusion: It is concluded that, in this patient, the cervical resorptions were likely the result of an osteoclastic response extending into the root s because the root-protective role of the junctional epithelium did not dev elop. We hypothesize that this was due to the combined effects of a periodo ntopathogenic microflora and a dietary confounding factor.