Morphological Study of Root Surfaces in Teeth With Adult Periodontitis

Background: Our study correlates the histological alterations in the cementum (especially resorption areas) of teeth with the different stages of adult periodontitis. Methods: Sixty‐seven teeth affected by adult periodontitis and 7 healthy teeth extracted from patients over 40 years old were used. The teeth were divided into 3 groups according to radiographic data: group 1: five teeth with bone loss less than one‐third of the normal alveolar height; group 2: thirty‐one teeth with bone loss between one and two thirds; and group 3: thirty‐one teeth with bone loss greater than two thirds. The samples were prepared for light and scanning electron microscopy, considering the gingival, middle, and apical thirds in each root. Results: Two control teeth, 4 teeth in group 1, and all teeth in groups 2 and 3 showed resorption areas. Regarding the gingival third, the control teeth did not show any resorption, while 25% of affected teeth in group 1, 38.7% of teeth in group 2, and 35.5% of teeth in group 3 exhibited resorption. Regarding the middle third, 50% of affected teeth belonging to the control group and group 1; 67.7% of teeth in group 2; and 87.1% of teeth in group 3 showed resorption. Regarding the apical third, all teeth belonging to the control group and group 1 showed resorption, while 93.5% and 87.1% of teeth in groups 2 and 3, respectively, exhibited resorption. Most of the resorptions did not extend beyond the cementum. However, in 29.0% of teeth in group 2 and 38.7% of teeth in group 3, resorption had spread as far as the dentin. All the lesions in the control group and group 1 were practically repaired, while only 71.0% of teeth in group 2 and 61.3% of teeth in group 3 showed some sign of reparation. However, in groups 2 and 3, practically all lesions affecting dentin were repaired. Conclusions: These data suggest that the spread of root resorption is associated with inflammation. This study also suggests that the capacity for repair of root resorption is diminished with greater severity of periodontitis. J Periodontol 1999;70:1283‐1291.