Dental and oral lesions in two patients with focal dermal hypoplasia (Goltz syndrome)

Multiple idiopathic apical root resorption: a case report

AIM

To report a rare case of multiple idiopathic apical root resorption in an adult male.

SUMMARY

A 27-year-old male with no history of medical or dental disorders was referred by his family dentist for evaluation of extreme root resorption involving the apical region of most of his teeth. A complete haematological investigation was conducted and all the results were within the normal range. Mobility of the teeth was physiologic and no abnormal periodontal pockets were observed. A diagnosis of multiple idiopathic apical root resorption was made.

KEY LEARNING POINTS

*Apical root resorption of multiple teeth can be related to no specific aetiology and is known as idiopathic apical root resorption. *It is mostly seen in young adult males; maxillary teeth are more frequently involved. *No preventive or therapeutic regimen is known and monitoring accompanied by periodontal maintenance is recommended.

Progressive, generalized, apical idiopathic root resorption and hypercementosis

BACKGROUND

Root resorption is a multifactorial process that results in loss of tooth structure. The causes of root resorption may vary, leading to several types of resorptions. Some factors have been identified and may be categorized into physiological resorption, local factors, systemic conditions, and idiopathic resorptions. The objective of this report was to present a case of a 17-year-old white female with progressive, generalized, apical idiopathic root resorption followed up for 34 months.

METHODS

Two panoramic radiographs, 14 and 34 months after initial clinical and radiological examinations, showed the rapid progression of apical root resorption. Two molars, teeth #15 and #16, which had to be extracted, and a bone sample from the distal aspect of tooth #15 were processed for histologic analysis.

RESULTS

Two millimeters apical to the cemento-enamel junction, an abrupt increase in the cementum thickness was noted, amounting to 300 and 800 microm in teeth #15 and #16, respectively. The thickening of the cementum layer was due to an accelerated deposition of cellular intrinsic fiber cementum. An unusually high number of mineralization foci were observed in association with acellular extrinsic fiber cementum, and both free and fused cementicles were seen. In contrast to tooth #16, tooth #15 revealed extensive dentin replacement by a bone-like and a cementum-like tissue. Furthermore, ankylosis was demonstrated in tooth #15 and confirmed in the bone sample.

CONCLUSIONS

At present, there is no preventive or therapeutic regimen for the type of root resorption seen in this case report. Treatment usually consists of the extraction of teeth with advanced lesions.