Diş Rezorpsiyonları
Özet
Diş rezorpsiyonu, koruyucu presement veya predentin tabakasının kaybı ve ardından korunmasız kök yüzeyinde enflamasyon oluşmasıyla gerçekleşen patolojik bir süreçtir. Bu durum Andreasen ve Lindskog gibi araştırmacılar tarafından travma, enfeksiyon ve hiperplastik invaziv kaynaklı olmak üzere üç ana grupta sınıflandırılmaktadır. Travmaya bağlı rezorpsiyonlar yüzey, geçici apikal internal, basınç, ortodontik ve diş kaybına yol açabilen replasman rezorpsiyonu gibi alt türlere ayrılır. Enfeksiyon kaynaklı rezorpsiyonlar ise endodontik patolojilerden köken alır; internal (apikal/intraradiküler), eksternal veya kombine lezyonlar olarak izlenir ve tedavilerinde kök kanalı debridmanı ile kalsiyum hidroksit, Ledermix patı veya MTA gibi antiklastik materyaller kullanılır. Üçüncü grup olan hiperplastik invaziv rezorpsiyonlar ise sinsi ve agresif karakterde olup dokunun fibroosseöz şekilde istilasıyla ilerler; bu grupta nedenin ortadan kaldırılması yetersiz kaldığından %90 triklorasetik asit ile kimyasal inaktivasyon veya cerrahi küretaj gibi agresif yaklaşımlar gerekir. Özellikle invaziv servikal rezorpsiyon gibi ileri evre vakalarda ortodontik ekstrüzyon ya da implant destekli protez alternatifleri klinik olarak değerlendirilmektedir.
Tooth resorption is a pathological process that occurs with the loss of the protective precementum or predentin layer, followed by the formation of inflammation on the unprotected root surface. This condition is classified by researchers like Andreasen and Lindskog into three main groups: trauma-induced, infection-induced, and hyperplastic invasive resorptions. Trauma-related resorptions are divided into subtypes such as surface, transient apical internal, pressure, orthodontic, and replacement resorption, which can lead to tooth loss. Infection-induced resorptions originate from endodontic pathologies, presenting as internal (apical/intraradicular), external, or combined lesions, and their treatment involves root canal debridement along with anticlastic materials like calcium hydroxide, Ledermix paste, or MTA. The third group, hyperplastic invasive resorptions, progresses insidiously and aggressively through fibro-osseous invasion of tissues; since simply removing the cause is insufficient, aggressive approaches like chemical inactivation with 90% trichloroacetic acid or surgical curettage are required. Particularly in advanced cases like invasive cervical resorption, orthodontic extrusion or implant-supported prosthetic alternatives are clinically evaluated.
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