Internal Root Restoration

Internal root resorption (IRR) may seem like a baffling phenomenon for many patients and their dentists, but this condition may occur more than they realize. According to the International Journal of Dentistry, the frequency of IRR is not well known and its occurrence is estimated to be somewhere between 0.01% and 55%. Although the condition is still considered to be rare, it's certainly not unheard-of in the world of dentistry.


IRR is a condition that begins when the root's innermost nerve tissue becomes inflamed as a result of tooth trauma. The nerve, or pulp, slowly eats away at the tooth's structure as it resorbs it. The nerve inside the tooth is still alive, but the patient doesn't feel pain during the early stages. However, if IRR isn't treated early enough, it does become painful if it progresses to the point of causing a tooth perforation. Treatment usually consists of root canal therapy and is most successful when it's done early. If IRR progresses all the way to the outer surface of the root, it's too late for reversal. In this case, tooth loss may be inevitable, but patients can often replace their missing tooth with a permanent dental implant.


Typically, internal root resorption is discovered through routine x-rays. There are two types of root resorption: internal and external. IRR begins at the innermost nerve center of the tooth, while external root resorption begins at the external surface and moves inward. When studying a patient's x-rays at the dentist office, IRR can be differentiated from external root resorption because the outline of the tooth's nerve center looks different. With IRR, the lesion appears to be within the nerve center of the tooth. In contrast, the outlines of the pulp and lesion are separate and recognizable with external root resorption. Because IRR isn't painful at first, regular dental check-ups and x-rays are critical for early detection. Otherwise, the condition may progress until tooth loss is the patient's only option. Our Mentor dentist office tries our best to detect IRR at the early stages.