Root Resorption Classifications: A Narrative Review and a Clinical Aid Proposal for Routine Assessment

Abstract

Root resorption (RR) refers to noninfectious damage related to the loss of hard and soft dental tissue thatresults from clastic cell activity. It is observed as a pathologic process that is predominantly asymptomaticin the permanent dentition and physiological during the shedding of primary teeth. Roots are protected byunmineralized organic cementoid and predentine. RR occurs because of the inability of the clastic cells toadhere to unmineralized surfaces. Since the first RR classification was described by Andreasen in the 1970s,several classifications have been proposed with diverse terminology. A narrative literature review was undertaken on the current classification, diagnosis, pathophysiology, and treatment of RR. A bibliographic searchresulted in 434 titles and abstracts, and from those, 17 articles were obtained that alluded to 15 RR classifications. A total of 28 articles that met the inclusion criteria were included. Results showed that Andreasen’sclassification is the most widely used for classifying RR. In terms of epidemiologic data, studies are scarce,although RR pathophysiology is well described in the literature. Overall clinical guidelines are summarized ina new RR classification diagram. The choice of RR treatment application should be in line with the RR type andthe dentist’s experience. However, an earlier and correct diagnosis will significantly improve final outcomesand long-term prognosis, especially with the current evolution of advanced imaging techniques, such ascone-beam computed tomography and bioceramic-based endodontic sealers