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. 2022 Mar 30;55(Suppl 4):892–921. doi: 10.1111/iej.13715

FIGURE 2.

FIGURE 2

Internal replacement resorption. Light microscopy images of a variant of internal (root canal) replacement resorption with tunnelling resorption. The lower right lateral incisor belonged to a 39‐year‐old former boxer who had suffered a jaw fracture in a boxing match in his early twenties and was placed in intermaxillary fixation. The patient developed symptoms 20 years later and complained of pain associated with his lower incisors. (a) Radiograph of the mandibular right incisors. The lower right central incisor had asymptomatic apical periodontitis associated with a necrotic and infected pulp. The lower right lateral incisor showed a large area of internal root resorption. The tooth did not respond to sensitivity tests. (b) Sagittal CBCT slice shows some calcified tissue in the resorptive defect. C, Cross section taken at the level of line 1 in (a) and (b). The overview shows that the canal was apparently empty at this level. (H&E stain; ×6). (d), High magnification of the area indicated by the arrow. (c) Lamellar bone filling an area of previous resorption. Note the osteon structure (arrow). (H&E stain; ×100). (e) Cross section taken at the level of line 2 in (a) and (b). Overview shows that the canal lumen was partly occupied by necrotic remnants, partly by bonelike tissue (H&E stain; ×8). (f), High magnification of the lower part in (e; H&E stain; ×50). (g), Higher magnification of (f). Bone trabeculae are surrounded by necrotic debris. (H&E stain; ×100). (h), Cross section taken from the same area. (Taylor's modified Brown & Brenn [TBB] stain; ×16). (i), High magnification of the area indicated by the arrow in (h). A fragment of bonelike tissue can be seen surrounded by bacteria‐colonized necrotic tissues. (TBB stain; ×100; inset ×1000). (j), Longitudinal section passing approximately through the center of the root apex. Dentin walls have been resorbed and replaced by a bonelike tissue. (H&E stain; ×16). (From Patel S, Ricucci D, Durack C, Tay F: Internal root resorption: a review, Journal of Endodontics 36:1107, 2010)