Volumetric Analysis of Resorption Types on CBCT

Study Overview
=================
Brief Summary
-----------------
More accurate management of resorption can be achieved thanks to the three-dimensions volumetric and linear analysis, and the axial classification presented in this study.

Detailed Description
-----------------
The aim of this study was to investigate the volumetric and linear analysis, and to present the axial classification of root resorptions using cone beam computed tomography (CBCT). A total of 43 teeth of external cervical resorption (ECR) (n=27), external replacement resorption (ERR) (n=4) and internal root resorption (IRR) (n=12) were identified from 34 patients. The volume of resorption and total tooth, the widest lengths of these resorptions, and the amount of thinnest dentin thickness around them were measured and compared according to age and sex. Additionally, the eight regional axial classification was performed and the percentages in these regions were evaluated. Significance was set at p=0.05 for statistical analysis. More accurate management of resorption can be achieved thanks to the three-dimensions volumetric and linear analysis, and the axial classification presented in this study.

Official Title
-----------------
Three-dimensional Volumetric/ Linear Analysis and Axial Classification of Root Resorptions Using Cone Beam Computed Tomography: A Retrospective Study

Conditions
-----------------
Endodontic Disease, Tooth Resorption

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Cases of resorption that had CBCT images Exclusion Criteria: those presenting pathologic lesions, congenital/developmental anomalies or teeth with root canal filling those whose CBCT scans failed to present satisfactory quality. Additionally, SR, TAP, and EIR cases were excluded because their true dimensions could not be completely determined before resorption.

Ages Eligible for Study
-----------------
Minimum Age: 12 Years
Maximum Age: 71 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group 1. Internal root resorption (IRR)<br>Internal root resorption is the progressive destruction of intraradicular dentin and dentinal tubules along the middle and apical thirds of the canal walls as a result of clastic activities. It is seen as a radiolucent area around the pulpal cavity, usually of incisors and mandibular molars. The various etiological factors suggested for internal root resorption include traumatic injury; infection and orthodontic treatment. | |
| Group 2. external cervical resorption (ECR)<br>Cementum is considered to protect the underlying root dentin from being resorbed. It is broadly accepted that damage to or deficiency of this protective cementum layer below the epithelial attachment exposes the root surface to osteoclasts, which then resorb the dentin. Clinical sign; Located in cervical region of tooth Pink spot might be noted by patient/dentist Tooth usually responds positively to vitality tests unless there is pulpal involvement (in very advanced cases) Spontaneous and profuse bleeding on probing Sharp, thinned out edges around the resorptive cavity | |
| Grup 3. external replacement resorption (ERR)<br>external replacement resorption also known as trauma-induced resorption - and this resorption may occur in teeth that also have external inflammatory resorption. This review will not discuss external replacement resorption in detail but it will be mentioned where relevant as both types of resorption may occur in some cases. This is because replacement resorption is a consequence of the same injuries that typically cause external inflammatory resorption - such as intrusion and avulsion where there is significant damage to the external root surface during the injury, as well as sometimes during the repositioning/ replantation of the tooth. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Volume of total tooth and resorbed area | The total volume and the resorption volume were measured with used 3D semi-automatic segmentation program (ITK-SNAP 2.4) | for three months from the beginning of the study | 
| Measurement widest mesio-distal length, bucco-lingual length and corono-apical length of the resorbed lesion | Linear measurement were measured with used Planmeca ProMax 3D Classic (Planmeca Promax 3D; Planmeca Oy; Helsinki, Finland) | for three months from the beginning of the study | 
| Linear measurements for thinnest dentin (buccal, distal, mesial and lingual/ palatinal) and resorbed area (mesio-distal length and bucco-lingual length) were made on axial sections | Linear measurement were measured with used Planmeca ProMax 3D Classic (Planmeca Promax 3D; Planmeca Oy; Helsinki, Finland) | for three months from the beginning of the study | 
| The corono-apical length was measured on sagittal sections where the tooth axis was perpendicular to the ground plane. | Linear measurement were measured with used Planmeca ProMax 3D Classic (Planmeca Promax 3D; Planmeca Oy; Helsinki, Finland) | for three months from the beginning of the study | 
| the axial section of the tooth was divided into eight parts and regional settlement classification was performed | Segmentation were made with used Planmeca ProMax 3D Classic (Planmeca Promax 3D; Planmeca Oy; Helsinki, Finland) | for three months from the beginning of the study | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
cone beam computed tomography, endodontics, tooth Resorption