  While tooth root resorption is a normal physiological process required for
resorption and exfoliation of primary teeth, root resorption of adult teeth is
largely pathological. This perspective focuses on multiple idiopathic cervical
root resorption (MICRR), an aggressive form of external root resorption that
occurs near the cemento-enamel junction (CEJ). The cause of MICRR remains
elusive, however, it is mediated primarily by osteoclasts/odontoclasts.
Accumulating case studies and experiments in animal models have provided
insights into defining the etiologies and pathophysiological mechanisms for
MICRR, which include: systemic conditions and syndromes, inherited genetic
variants affecting osteoclast/odontoclast activity, altered periodontal
structures, drug-induced root resorption and rebound effects after cessation of
anti-resorptive treatment, chemotherapy, exposure to pets or viral infections,
and other factors such as inflammatory conditions or trauma. To determine the
causative factors, at minimum, a comprehensive health history should be
collected for all patients by dental care providers, discussed with other
health care providers and appropriate collaborations established. The examples
highlighted in this perspective emphasize the need for transdisciplinary
research collaborations coupled with integrated management strategies between
medicine and dentistry in order to identify cause(s) early and improve clinical
outcomes.
