title: Examination of external apical root resorption with scanning electron microscopy.
abstract: External apical root resorption may be evident histologically but not visible radiographically until it is advanced. If working length is determined without considering this resorption, overinstrumentation or overfilling may occur.
  
  
  OBJECTIVE
  This study used scanning electron microscopy to examine the appearance and to compare the incidence of external apical root resorption in 40 teeth with differing pulpal and periapical diagnoses.
  
  
  METHODS
  After extraction, 46 roots were sectioned horizontally 6 mm from the anatomic apex and prepared for scanning electron microscopy examination. Photomicrographs were scored by two blinded independent examiners. Apical resorption was categorized as: none, partial, or complete. Presence or absence of a funneling appearance of the resorption was also recorded.
  
  
  RESULTS
  Kruskal Wallis showed a significant difference in resorption between groups; teeth with irreversible pulpitis/normal periapex had the least resorption. Duncan's multiple range test found radiographic apical lesions to have more resorption than those without lesions; teeth with necrotic pulps had more resorption than those with vital pulps.
  
  
  CONCLUSIONS
  Pulp necrosis with radiolucent apical pathosis is more likely to demonstrate resorption.
authors.affiliation: Department of Endodontics, University of Iowa College of Dentistry, Iowa City, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Malueg
authors.forename: L R
authors.initials: LR
authors.lastname: Wilcox
authors.forename: W
authors.initials: W
authors.lastname: Johnson
mesh_terms: D016009:Chi-Square Distribution; D003790:Dental Pulp Necrosis / Q000150:complications; D006801:Humans; D008855:Microscopy, Electron, Scanning; D009811:Odontometry / Q000379:methods; D010482:Periapical Abscess / Q000150:complications; D010485:Periapical Periodontitis / Q000150:complications; D011671:Pulpitis / Q000150:complications; D012391:Root Resorption / Q000209:etiology / Q000473:pathology*; D018709:Statistics, Nonparametric; D019227:Tooth Apex / Q000648:ultrastructure*