Orthodontically Induced External Apical Root Resorption in Class II Malocclusion

Orthodontic-induced external apical root resorption is one of the idiopathic phenomena as an effect, with force generated through mechanotherapy as the cause and the biological tissues with their diversified variations as witness. It is also classified as iatrogenic as a result of indeterminate application of orthodontic forces with subconscious appreciation of the existing underlying conditions. Numerous factors were identified to relate to this irreversible pathologic condition, but none were proven scientifically. Genetics and salivary markers have proved the reliability with time, but the application became insignificant limiting mostly to the research field. Different assessment methods were also identified to clinically diagnose it both subjectively and objectively. Mostly, it is identified through routine radiographic stage records like orthopantomogram or certain prediction radiographs for root resorption probability assessment like in this case. This case report discusses one such encounter which was experienced after stage 1 and 2 mechanics involving quite a few teeth. Considering the biotype of the individual and tooth morphology, the ongoing treatment was terminated and recovery measures were briefed to uplift the self-esteem of the individual. Furthermore, the prognosis is compromised to be very poor with unpredictability to any other treatment modalities.

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Apical root resorption caused by orthodontic forces: A brief review and a long-term observation

European Journal of Dentistry ◽

10.1055/s-0039-1698986 ◽

2012 ◽

Vol 06 (04) ◽

pp. 445-453 ◽

Cited By ~ 27

Author(s):

Ahu Topkara ◽

Ali I Karaman ◽

Chung H Kau

Keyword(s):

Root Resorption ◽

Cone Beam ◽

Apical Root Resorption ◽

Long Term Follow Up ◽

Orthodontic Patients ◽

External Apical Root Resorption ◽

Long Term Observation ◽

Orthodontic Forces

ABSTRACTExternal apical root resorption (ARR) is a common iatrogenic consequence of orthodontic treatment. One of the aims of this article is to present a brief overview of the literature, including; diagnosis and etiology, with emphasis on orthodontic forces to facilitate an understand of the prevention or management of ARR in orthodontic patients. We also present a long-term follow-up observation of severe ARR, including the last obtained cone beam computed tomography (CBCT) records, to demonstrate the effect of orthodontic forces on ARR. (Eur J Dent 2012;6:445-453)

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Comparison of external apical root resorption with clear aligners and pre-adjusted edgewise appliances in non-extraction cases: a systematic review and meta-analysis

European Journal of Orthodontics ◽

10.1093/ejo/cjaa013 ◽

2020 ◽

Author(s):

Vaibhav Gandhi ◽

Shivam Mehta ◽

Marissa Gauthier ◽

Jijian Mu ◽

Chia-Ling Kuo ◽

...

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Root Resorption ◽

Meta Analysis ◽

Treatment Modalities ◽

Cochrane Central Register ◽

Apical Root Resorption ◽

External Apical Root Resorption ◽

The Mean ◽

Maxillary Incisors

Summary Objective The aim of this study was to evaluate and compare the amount of external apical root resorption (EARR) observed during the orthodontic treatment with pre-adjusted edgewise appliance (PEA) or clear aligner therapy (CAT) and with 2D or 3D radiographic methods of measuring the root resorption. Search strategy and selection criteria A search of PubMed MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, LILACS, Web of Science, Dissertations & Theses Global, ClinicalTrials.gov registry, and the ISRCTN Registry was performed. Studies that have evaluated the amount of root resorption in non-extraction cases using CAT or PEA were selected for the systematic review. A meta-analysis was performed for the amount of root resorption of permanent maxillary incisors using PEA or CAT treatment modalities by either 2D or cone-beam computed tomography radiographic examination. Data collection and analysis Database research, elimination of duplicate studies, data extraction, and risk of bias were performed by authors independently and in duplication. A random-effect meta-analysis followed by subgroup comparisons were performed to evaluate EARR. Results A total of 16 studies (4 were prospective and 12 were retrospective) were identified for inclusion in the systematic review. The mean root resorption for the permanent maxillary incisors was in the range from 0.25 to 1.13 mm (overall: 0.49 mm; 95% confidence interval [CI] = 0.24 to 0.75 mm). The mean root resorption difference between CAT and PEA was statistically significant (P < 0.05) for 12 but not for 21, 11, or 22. Limitations One of the drawbacks is a lack of good quality prospective studies, specifically randomized clinical trials in the literature. Conclusions and implications Neither PEA or CAT technique leads to clinically significant root resorption (1 mm) of the maxillary incisors. The amount of EARR of maxillary incisors is not significant in comparing two treatment modalities (PEA and CAT), except for 12, where the PEA group has significantly more EARR when compared to CAT. Registration The protocol for this systematic review was based on the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and was registered at PROSPERO database (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018113051). This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

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