Is it possible for both inflammatory and replacement…
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At 4-month follow-up of a replanted incisor, the radiograph shows both a periapical radiolucency (suggesting infection) AND areas where root appears to be fusing with surrounding bone (suggesting ankylosis). The patient asks if this means the tooth is lost. Is it possible for both inflammatory and replacement resorption to occur in the same tooth?
- A. No — inflammatory and replacement resorption are mutually exclusive pathological processes
- B. No — if one type is present, it suppresses the biological pathway for the other type entirely
- C. Yes — the IADT specifically notes that the two types of resorption may occur concurrently
- D. Yes — but only in teeth that were stored in water, which triggers both pathways simultaneously
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IADT: 'It is worth noting that the two types of resorption may occur concurrently.' Inflammatory resorption is infection-driven (treatable with endodontics), while replacement resorption reflects PDL necrosis (progressive, irreversible). SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 11
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