Čes. stomatol. Prakt. zub. lék. (Czech Dental Journal) 2026; 126(2): 41-53

MANAGEMENT OF ROOT RESORPTION IN CLINICAL PRACTICE

Fritzká S.^{1, 2}, Tamášová M.^{1, 2}

¹ I. stomatologická klinika, Lekárska fakulta, Univerzita Pavla Jozefa Šafárika v Košiciach, Slovenská republika

² I. stomatologická klinika, Univerzitná nemocnica L. Pasteura, Košice, Slovenská republika

Introduction and aim: Root resorption represents an irreversible process characterized by the loss of dental hard tissues due to odontoclastic activity. While, in the primary dentition, it is a physiological phenomenon, in the permanent dentition, it invariably reflects a pathological condition, most commonly associated with trauma and/or persistent stimulátory factors. Despite extensive research, the aetiology of root resorption has not yet been fully elucidated, and its therapeutic management thus remains complex and clinically demanding. The introduction of advanced imaging technologies has significantly enhanced the possibilities for early detection of resorptive processes as well as for the accurate assessment of lesion extent. The management of root resorptions requires a highly coordinated interdisciplinary strategy integrating restorative, endodontic, surgical, prosthodontic and orthodontic interventions. The synergy of these disciplines is essential for precise diagnosis, effective control of pathological progression, and preservation of functional and structural integrity of the affected teeth. The aim of this review article is to summarise current knowledge on the aetiology, diagnosis, and treatment of root resorption, with an emphasis on clinical practice and the interdisciplinary approach that is frequently required in its therapeutic management.

Methodology: This review is based on an analysis of scholarly publications in Slovak and English languages. Sources were retrieved from the PubMed database as well as from professional periodicals including Zdravotnícke noviny, Stomatológ, International Journal of Applied Dental Sciences, Australian Endodontic Journal, and the Journal of Dentistry Indonesia. The search was conducted using the following key words: internal root resorption, external root resorption, endodontic treatment, CBCT, MTA, Biodentine.

Results: The most significant predisposing factors for external root resorption include orthodontic treatment, dental trauma, improper use of bleaching agents, and infectious apical periodontitis. Internal resorption is most frequently observed in association with severe traumatic injuries such as avulsion and intrusive luxation. Cone-beam computed tomography (CBCT) is currently considered the most reliable tool for early detection of resorptive lesions. Internal inflammatory resorption is most commonly diagnosed following traumatic injury to the pulp and typically affects the anterior maxillary region. External inflammatory resorption has been shown to be associated with infection originating from a necrotic pulp and is characterized by rapid progression. With regard to therapeutic strategies, endodontic treatment using flowable gutta-percha or warm obturation techniques remains the standard approach for internal resorption, as these methods allow homogeneous adaptation of the material in irregular defects. For perforations and cervical resorptive defects, mineral trioxide aggregate (MTA) and Biodentine represent the most effective biomaterials. Resorptive lesions associated with impacted teeth confirm the predominant role of mechanical pressure in the development of external surface and cervical root destruction of adjacent teeth.

Conclusion: Internal and external root resorption represent relatively uncommon but clinically significant conditions that have received increasing attention in recent years. Conservative endodontic treatment remains the primary therapeutic approach for internal resorption and perforation defects, while bioactive materials (MTA, Biodentine) continue to be regarded as the preferred materials due to their high biocompatibility and capacity to promote tissue healing. The management of external resorption, particularly cervical and pressure-induced forms, is often complex and requires coordinated collaboration among endodontic, orthodontic, surgical, and prosthodontic disciplines.

Keywords: internal root resorption, external root resorption, CBCT, endodontic treatment, MTA, Biodentine

Received: May 27, 2025; Revised: January 11, 2026; Accepted: January 25, 2026; Prepublished online: May 26, 2026; Published: June 9, 2026  Show citation