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Pathological resorption is diagnosed quite often in the treatment of periodontitis and is considered a prognostic adverse symptom. Increasing the effectiveness of the therapeutic treatment of destructive periodontitis is associated with the development of methods of instrumental and drug effects on root canals and depends on the correct selection of endo-sealant to achieve the predicted result. The combined pathology of root resorption is no exception in the case of a correctly chosen treatment strategy. The article reports on the successful therapeutic treatment of a tooth with destructive periodontitis and combined root resorption. Radiographically proven that there is a complete recovery of periapical tissues. Long-term results indicate the effectiveness of the treatment.

Aim. To study morphology of external resorption of apical root area of teeth with destructive forms of apical periodontitis in the acute stage.Materials and methods. Microrelief of 10 previously untreated teeth with destructive forms of apical periodontitis in the acute stage was investigated. The material was taken at the moment of dental manipulation of tooth extraction after injecting anesthesia with 2% lidocaine solution or Septanest if indicated with the information consent of the patient.Results. Damaged cement of heterogeneous structure with areas of resorption alternating with areas of undamaged cement in the area of the root tips was found. The resorbed cement looks like large lacunae with clearly outlined ribs, filled with rounded cell clusters – cementocytes.Conclusions. Resorbed tooth root cement of heterogeneous structure with different area and degree of destruction depth was found in the places of periodontal absence. In some cases the resorption of the root cement partially affected the inner area of the apical orifice.