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Severe Root Resorption with Pulp Fibrosis Despite Normal Responses to Pulp Sensibility Tests : A Case Report
| 名前 / ファイル | ライセンス | アクション |
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odep_5_1_70.pdf (1.5 MB)
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| アイテムタイプ | 文献 / Documents(1) | |||||||||||||||||||||||||||||||||||
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| 公開日 | 2026-02-18 | |||||||||||||||||||||||||||||||||||
| アクセス権 | ||||||||||||||||||||||||||||||||||||
| アクセス権 | open access | |||||||||||||||||||||||||||||||||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||||||||||||||||||||||||||||||||
| 資源タイプ | ||||||||||||||||||||||||||||||||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||||||||||||||||||||||||||||||||
| 資源タイプ | journal article | |||||||||||||||||||||||||||||||||||
| 出版社版DOI | ||||||||||||||||||||||||||||||||||||
| 関連識別子 | https://doi.org/10.11471/odep.2025-008 | |||||||||||||||||||||||||||||||||||
| 関連名称 | 10.11471/odep.2025-008 | |||||||||||||||||||||||||||||||||||
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| 出版タイプ | VoR | |||||||||||||||||||||||||||||||||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||||||||||||||||||||||||||||||||
| タイトル | ||||||||||||||||||||||||||||||||||||
| タイトル | Severe Root Resorption with Pulp Fibrosis Despite Normal Responses to Pulp Sensibility Tests : A Case Report | |||||||||||||||||||||||||||||||||||
| タイトル別表記 | ||||||||||||||||||||||||||||||||||||
| その他のタイトル | Root Resorption with Pulp Fibrosis | |||||||||||||||||||||||||||||||||||
| 著者 |
武川, 大輔
× 武川, 大輔
WEKO
566
× 内藤, 禎人
WEKO
390
× 可児, 耕一
WEKO
634
× 常松, 貴明
WEKO
813
× 蔵本, 瞳× 中西, 正
WEKO
1704
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| 抄録 | ||||||||||||||||||||||||||||||||||||
| 内容記述 | Purpose: We report a rare case of atypical external root resorption in the mid-root region of a mandibular molar following direct pulp capping (DPC), despite the tooth consistently exhibiting normal responses to pulp sensibility tests. We discuss the diagnostic challenges presented by such cases, focusing on the limitations of conventional pulp testing, the potential role of pathological pulp fibrosis, and the importance of cone-beam computed tomography (CBCT) in early detection and accurate diagnosis. Case: A 38-year-old male patient presented with a chief complaint of chronic discomfort and distal gingival swelling in the right mandibular second molar. The tooth had undergone DPC with calcium hydroxide nine years earlier due to pulp exposure following complete caries removal. Clinical examination revealed mild gingival swelling and slight tenderness to percussion, with normal periodontal probing depths. The electric pulp test (EPT) and cold test showed normal responses, which were consistent with the results from a previous visit six years earlier. A dental radiograph taken six years earlier showed no abnormalities; however, comparison with the radiograph obtained at presentation revealed extensive external root resorption localized to the mid-root area of the mesial root. CBCT images confirmed that the resorption had perforated the dentin and reached the pulp chamber, accompanied by substantial loss of lingual alveolar bone. The prognosis was ultimately deemed poor, and the tooth was extracted. The extracted tissue was subjected to histopathological examination using hematoxylin and eosin staining. Histopathological analysis revealed extensive fibrosis in the pulp tissue without bacterial infection. In addition, chronic inflammatory granulation tissue, mainly with neutrophil infiltration, was observed in the area of external root resorption. Discussion: This case highlights the limitations of relying solely on pulp sensibility tests for assessing pulp health. Especially in teeth with a history of DPC and chronic symptoms, underlying pathological changes, such as fibrosis, may not alter nerve responses until later stages. Atypical external root resorption can occur secondary to these changes, potentially progressing significantly without typical symptoms or radiographic signs on conventional 2D imaging. CBCT proved useful for identifying the precise location, extent, and perforation of the resorption lesion, underscoring its value in diagnosing complex endodontic-periodontal conditions. Conclusion: Early use of CBCT should be considered in teeth with persistent symptoms after DPC, even in patients with normal pulp sensibility tests results, to facilitate timely diagnosis and appropriate management. |
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| 主題 | root resorption | |||||||||||||||||||||||||||||||||||
| キーワード | ||||||||||||||||||||||||||||||||||||
| 主題 | electric pulp test (EPT) | |||||||||||||||||||||||||||||||||||
| キーワード | ||||||||||||||||||||||||||||||||||||
| 主題 | cone-beam computed tomography (CBCT) | |||||||||||||||||||||||||||||||||||
| 書誌情報 |
en : Operative Dentistry, Endodontology and Periodontology 巻 5, 号 1, p. 70-76, 発行日 2025-12-31 |
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| 収録物識別子タイプ | EISSN | |||||||||||||||||||||||||||||||||||
| 収録物識別子 | 24364975 | |||||||||||||||||||||||||||||||||||
| 出版者 | ||||||||||||||||||||||||||||||||||||
| 出版者 | Japanese Society of Conservative Dentistry | |||||||||||||||||||||||||||||||||||
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| 識別子 | 459255 | |||||||||||||||||||||||||||||||||||
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| 言語 | eng | |||||||||||||||||||||||||||||||||||
