A rare side effect of vital pulp therapy (VPT) is internal root resorption (IRR), a damaging process in which clastic cells, triggered by pulpal inflammation, dissolve dentin from within the tooth's pulp chamber or root canal. Cone-beam computed tomography (CBCT) is commonly used for diagnosis, and early discovery, elimination of the underlying cause, and proper treatment—such as filling the resorptive defect with a substance like Biodentine—are necessary for successful management. What is Internal Root Resorption? · Process: As clastic cells eat away at the dentin and dentinal tubules, IRR causes the gradual internal loss of root dentin. · Cause: Although other causes may also play a role, pulpal inflammation or damage is frequently the initial cause. · Clinical Signs: A tooth with internal resorption may seem pink because of the increased visibility of blood vessels through the thinning dentin, even though it is frequently asymptomatic and found during normal dental checkups. Internal Root Resorption and Vital Pulp Therapy · Complication:After a vital pulp treatment (VPT) surgery, IRR is regarded as a rare but dangerous consequence. · Management: A case study describes how Biodentine was used to fill the resorptive defect following a platelet-rich fibrin (PRF) pulpotomy, successfully managing IRR. A year-long follow-up revealed a favorable result. Diagnosis and Treatment · Diagnosis: Cone-beam computed tomography (CBCT), a type of advanced imaging that clearly displays the smooth, well-defined radiolucent area of the expanded pulp space, is essential for correctly diagnosing IRR. · Treatment: A successful outcome depends on early diagnosis and action. Depending on how severe the lesion is, treatment options may include root canal therapy to seal the resorption, particularly if there has been a perforation or the tooth structure is severely compromised.
G. et al. (2026) studied this question.