scholarly journals Predisposing factors to severe external root resorption associated to orthodontic treatment

2013 ◽  
Vol 18 (1) ◽  
pp. 110-120 ◽  
Author(s):  
Gracemia Vasconcelos Picanço ◽  
Karina Maria Salvatore de Freitas ◽  
Rodrigo Hermont Cançado ◽  
Fabricio Pinelli Valarelli ◽  
Paulo Roberto Barroso Picanço ◽  
...  

OBJECTIVE: The aim of this study was to evaluate predisposing factors among patients who developed moderate or severe external root resorption (Malmgren's grades 3 and 4), on the maxillary incisors, during fixed orthodontic treatment in the permanent dentition. METHODS: Ninety-nine patients who underwent orthodontic treatment with fixed edgewise appliances were selected. Patients were divided into two groups: G1 - 50 patients with no root resorption or presenting only apical irregularities (Malmgren's grades 0 and 1) at the end of the treatment, with mean initial age of 16.79 years and mean treatment time of 3.21 years; G2 - 49 patients presenting moderate or severe root resorption (Malmgren's grades 3 and 4) at the end of treatment on the maxillary incisors, with mean initial age of 19.92 years and mean treatment time of 3.98 years. Periapical radiographs and lateral cephalograms were evaluated. Factors that could influence the occurrence of severe root resorption were also recorded. Statistical analysis included chi-square tests, Fisher's exact test and independent t tests. RESULTS: The results demonstrated significant difference between the groups for the variables: Extractions, initial degree of root resorption, root length and crown/root ratio at the beginning, and cortical thickness of the alveolar bone. CONCLUSION: It can be concluded that: Presence of root resorption before the beginning of treatment, extractions, reduced root length, decreased crown/root ratio and thin alveolar bone represent risk factors for severe root resorption in maxillary incisors during orthodontic treatment.

2013 ◽  
Vol 9 (1) ◽  
Author(s):  
Elena Krieger ◽  
Thomas Drechsler ◽  
Irene Schmidtmann ◽  
Collin Jacobs ◽  
Simeon Haag ◽  
...  

Abstract Introduction Objective of this study was to investigate the incidence and severity of apical root resorptions (ARR) during orthodontic treatment with aligners. Materials and methods The sample comprised 100 patients (17–75 years of age) with a class I occlusion and anterior crowding before treatment, treated exclusively with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA). The following teeth were assessed: upper and lower anterior teeth and first molars. Root and crown lengths of a total of 1600 teeth were measured twice in pre- and post-treatment panoramic radiographs. Afterwards, relative changes of the root length during treatment were calculated by a root-crown-ratio taking pre- and post-treatment root and crown lengths into consideration. A reduction of this ratio was considered as a shortening of the initial root length. Additionally, tooth movements of the front teeth were assessed by lateral cephalograms and the 3-dimensonal set up of each patient. Results All patients had a reduction of the pre-treatment root length with a minimum of two teeth. On average 7.36 teeth per patient were affected. 54% of 1600 measured teeth showed no measurable root reduction. A reduction of >0%-10% of the pre-treatment root length was found in 27.75%, a distinct reduction of >10%-20% in 11.94%. 6.31% of all teeth were affected with a considerable reduction of >20%. We found no statistically significant correlation between relative root length changes and the individual tooth, gender, age or sagittal and vertical orthodontic tooth movement; except for extrusion of upper front teeth, which was considered as not clinical relevant due to the small amount of mean 4% ARR. Conclusions The present study is the first analyzing ARR in patients with a fully implemented orthodontic treatment with aligners (i.e. resolving anterior crowding). The variety was high and no clinical relevant influence factor could be detected. A minimum of two teeth with a root length reduction was found in every patient. On average, 7.36 teeth per patient were affected.


2017 ◽  
Vol 17 (1) ◽  
pp. 23-28
Author(s):  
Ieva Gavare ◽  
Ilga Urtane ◽  
Gundega Jakobsone ◽  
Laura Neimane

Summary Introduction. Although severe root resorption is rare, it is a side effect of orthodontic treatment which affects tooth prognosis. Patients with severe dentofacial deformity, for whom orthodontic treatment and orthognathic surgery was done at the age of 18 and later, had long duration orthodontic treatment and orthognathic surgery, and are at a high risk of root resorption. The impact of orthognathic surgery on root resorption has not been sufficiently studied, and therefore is an interesting topic to research. Aim of the Study. To identify the risk factors for apical root resorption of maxillary incisors and canines as a result of orthodontic and surgical treatment of Class III malocclusion involving LeFort I osteotomy. Material and methods. The root lengths of upper incisors and canines were measured on cone beam computer tomography (CBCT) scans obtained from a database of orthognathic surgery patients. As a criteria for root resorption was chosen the difference in root lengths between different time points. The measurements were performed using the scans taken before orthodontic treatment (T1), before surgery (T2), and after post surgery orthodontic treatment (T3), of 28 subjects, aged 20.5 ± 3.81 years, with the mean presurgery treatment time of 19.9 ± 8.8 months, and post-surgery time of 7.1 ± 3.1 months. Changes in root lengths during different time spans were correlated with treatment duration, the initial crown/root ratio, and the severity of dentofacial deformity (Wits appraisal, ANB angle, and overjet). Results. During T1 - T2 the roots of the lateral incisors shortened by a maximum of 0.78 ± 0.83 mm (p < 0.001), at a rate of 0.04 mm per month. During T2 - T3 the lengths of the central incisor roots decreased most by 0.49 ± 0.52 (p < 0.001) at a rate of 0.07 mm per month. The resorption speed for canines increased from 0.03 mm to 0.1 mm per month before and after surgery. There were statistically significant correlations between the crown-root ratio and the incisor root length (r = 0.319 for lateral and r = 303 for central, both p<0,05) and for canines (r = 482, p<0.01). The associations between the shortened root length, in different time spans for different teeth, and the severity of malocclusion were inconsistent. Conclusions. Overall, the shortened root length during combined orthodontic and surgical treatment might not be clinically significant. After surgery, the rate of root resorption (mm per month) increased, especially for canines. The teeth with initially shorter roots showed more resorption during treatment.


2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Vaishnavi D ◽  
◽  
Harshitha V ◽  
Kishore K ◽  
◽  
...  

Background: Maxillary anterior teeth play a crucial role in aesthetics, phonetics, and mastication. For successful orthodontic treatment evaluating the morphology of the alveolar bone and incisive canal would help in avoiding root resorption, dehiscence, and fenestration. This study is aimed to research the configurational relationships among maxillary incisors, alveolar bone, and incisive canal through Cone Beam Computerated Tomography (CBCT). Methods: CBCT images of 35 orthodontic patients were evaluated for length of the canal (L); angles between the palatal plane and the maxillary alveolar border (01),the incisive canal (02), and maxillary incisor (03); distance from the right maxillary incisor to the incisive canal (D). All the measurements were performed on sagittal plane with the exception of (D) which was made on axial plane. Statistical analysis was performed on the above parameters using two sample test and Pearson’s correlation analysis. Results: There was no statistically significant difference between males and females for all the variables although there were large interindividual variation. There was a positive moderate correlation between 01 and 02 (0.480), 01 and 03 (0.487), 02 and 03 (0.345). The mean value for L and D were 10.38mm and 4.14mm respectively. Conclusion: There exists a large interindividual variability for incisive canal, proximity of incisors with that of incisive canal which could not be precisely predicted by the conventional cephalograms. The results of the study could be helpful clinically in planning orthodontic treatment for significant intrusion and retraction of maxillary incisors


2017 ◽  
Vol 63 (3) ◽  
pp. 124-127
Author(s):  
Anca Nicoleta Temelcea ◽  
◽  
Paula Perlea ◽  
Irina Maria Gheorghiu ◽  
Alexandru Iliescu ◽  
...  

The therapy of dento-maxillary annomalies involves the use of orthodontic forces acting on the teeth, periodontium and alveolar bone, producing changes in their structure, resulting in final dental movement. The application of orthodontic forces should be done with extreme caution to avoid the occurrence of traumatic root resorption or aggravation when acting on a weak ground. The article aims to identify the particularities of orthodontic treatment in the etiology of external traumatic root resorbtions.


2016 ◽  
Vol 6 ◽  
pp. 265-270 ◽  
Author(s):  
Shailesh Mohanlal Bhandari

This case report demonstrates an orthodontic method that offers short treatment time and the ability to simultaneously reshape and increase the buccolingual thickness of the supporting alveolar bone. A 23-year-old female with Angle’s Class I moderately to severely crowded malocclusion with periodontal pocket with 31 and reduced thickness of the buccal cortical plate of lower anteriors, requested shortened orthodontic treatment time. This surgery technique included buccal full-thickness flaps, selective partial decortication of the cortical plates, concomitant bone grafting/augmentation, and primary flap closure. Following the surgery, orthodontic adjustments were made approximately every 2 weeks. From bracketing to debracketing, the case was completed in approximately 7 months and 3 weeks. Posttreatment evaluation of patient revealed good results. Preexisting thin labial bony cortical plate with lower anteriors was covered. This finding suggests credence to the incorporation of the bone augmentation procedure into the corticotomy surgery because this made it possible to complete the orthodontic treatment with a more intact periodontium. The rapid expansive tooth movements with no significant apical root resorption may be attributed to the osteoclastic or catabolic phase of the regional acceleratory phenomenon.


2013 ◽  
Vol 18 (5) ◽  
pp. 91-98 ◽  
Author(s):  
Paulo Roberto Barroso Picanço ◽  
Fabricio Pinelli Valarelli ◽  
Rodrigo Hermont Cançado ◽  
Karina Maria Salvatore de Freitas ◽  
Gracemia Vasconcelos Picanço

OBJECTIVE: To compare, through computed tomography, alveolar bone thickness changes at the maxillary incisors area during orthodontic treatment with and without tooth extraction. METHODS: Twelve patients were evaluated. They were divided into 2 groups: G1 - 6 patients treated with extraction of right and left maxillary first premolars, with mean initial age of 15.83 years and mean treatment length of 2.53 years; G2 - 6 patients treated without extraction, with mean initial age of 18.26 years and mean treatment length of 2.39 years. Computed tomographies, lateral cephalograms and periapical radiographs were used at the beginning of the treatment (T1) and 18 months after the treatment had started (T2). Extraction space closure occurred in the extraction cases. Intragroup and intergroup comparisons were performed by dependent and independent t test, respectively. RESULTS: In G1, the central incisor was retracted and uprighted, while in G2 this tooth showed vestibularization. Additionally, G1 presented a higher increase of labial alveolar bone thickness at the cervical third in comparison with G2. The incidence of root resorption did not present significant differences between groups. CONCLUSION: There were no changes in alveolar bone thickness when extraction and nonextraction cases were compared, except for the labial alveolar bone thickness at the cervical third of maxillary incisors.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Talar S. Zeitounlouian ◽  
Kinan G. Zeno ◽  
Bassel A. Brad ◽  
Rania A. Haddad

Abstract Background The role of injectable platelet rich fibrin (i-PRF) in orthodontic treatment has not been investigated with focus on its effect on dental and bony periodontal elements. Objective To evaluate the efficacy of i-PRF in bone preservation and prevention of root resorption. Methods A randomized split-mouth controlled trial included 21 patients aged 16–28 years (20.85 ± 3.85), who were treated for Class II malocclusion with the extraction of the maxillary first premolars. Right and left sides were randomly allocated to either experimental treated with i-PRF or control sides. After the leveling and alignment phase, the canines were retracted with 150gm forces. The i-PRF was prepared from the blood of each patient following a precise protocol, then injected immediately before canine retraction on the buccal and palatal aspects of the extraction sites. Localized maxillary cone beam computed tomography scans were taken before and after canine retraction to measure alveolar bone height and thickness and canine root length (indicative of root resorption), and the presence of dehiscence and fenestration. Paired sample t-tests and Wilcoxon signed rank tests were used to compare the changes between groups. Results No statistically significant differences in bone height, bone thickness were found between sides and between pre- and post-retraction period. However, root length was reduced post retraction but did not differ between sides. In both groups, postoperative dehiscence was observed buccally and palatally and fenestrations were recorded on only the buccal aspect. Conclusions I-PRF did not affect bone quality during canine retraction or prevent canine root resorption. I-PRF did not reduce the prevalence of dehiscence and fenestration. Trial registration ClinicalTrials.gov (identifier number: NCT 03399760. 16/01/2018).


Author(s):  
Gupta V

In today's era, there is an increased demand for orthodontic treatment, especially among young patients. The greatest concern amongst the patients undergoing orthodontic treatment is the increased treatment time. The fixed orthodontic treatment lasts up to 2 to 3 years which further increases the risk of complications associated with the treatment such as external root resorption, periodontal problems, and patient compliance [1]. Clinicians are constantly striving towards developing strategies to enhance the rate of orthodontic tooth movement and decreasing the treatment time. Numerous surgical modalities found to be highly effective in reducing the treatment time for orthodontic therapy include corticotomy, corticision, peizocision, periodontal distraction, dentoalveolar distraction etc. [2]. Wilcko et al. [3] introduced the combined approach corticotomy surgery with alveolar grafting in a technique referred to as Accelerated Osteogenic Orthodontics (AOO) and recently known as Periodontally accelerated osteogenic orthodontics (PAOO). Many studies dictated that PAOO is an extremely predictable, safe, effective technique. The risk of root resorption and the duration of treatment time is considerably reduced [3-5]. The present article focuses on accelerating the orthodontic tooth movement using a Demineralized dentin matrix (DDM) graft, alloplast and PRF membranes to reduce the treatment time and improves soft and hard tissue healing outcomes.


2003 ◽  
Vol 40 (4) ◽  
pp. 343-350 ◽  
Author(s):  
G. Dewinter ◽  
M. Quirynen ◽  
K. Heidbüchel ◽  
A. Verdonck ◽  
G. Willems ◽  
...  

Objectives To evaluate the dental and periodontal condition of patients with unilateral cleft lip and palate (UCLP) before orthodontic treatment and evaluate whether the dental and periodontal condition of these patients during and after orthodontic treatment was jeopardized by the duration of the orthodontic and surgical treatment. Design Seventy-five individuals with UCLP (52 males, 23 females), between ages 8 and 20 years, participated in a retrospective study during their final follow-up visit with regard to dental abnormalities, such as hypodontia, external root resorption, crown and root malformation, and supernumerary teeth. Alveolar bone height and periodontal attachment loss on the cleft side were also screened before or after bone grafting and at different stages of orthodontic treatment. Results Hypodontia of the lateral incisor was found in more than 50% of the patients on the cleft side. Second premolars and/or lateral incisors outside the cleft area were missing in 27.2% of the patients. In 32%, malformations of the teeth near the cleft were noticed. In general, the teeth around and in the cleft of the patients showed normal septal bone heights and a healthy periodontium. Sixty of the 75 patients received a bone graft to restore the interrupted alveolar process. In 93.3% of these patients, the cleft was grafted before the eruption of the canine. Conclusion The periodontium of the teeth in and around the cleft in patients with UCLP observed during and after orthodontic treatment can cope relatively well with the long orthodontic treatment and combined surgical interventions. The children, who had not yet started treatment, also showed enough bone support and no periodontal problems of the teeth besides the cleft. Early secondary bone grafting seems to give optimal periodontal results.


2006 ◽  
Vol 76 (6) ◽  
pp. 1074-1082 ◽  
Author(s):  
Shoichiro Iino ◽  
Sumio Sakoda ◽  
Shouichi Miyawaki

Abstract We performed an orthodontic treatment combined with corticotomy and the placement of titanium miniplates in an adult patient who desired a shortened treatment period. The patient had an Angle Class I malocclusion with flaring of the maxillary and mandibular incisors. First, titanium miniplates were placed into the buccal alveolar bone of the maxilla for absolute orthodontic anchorage. Second, an edgewise appliance was applied to the maxillary and mandibular teeth. Then, the maxillary first premolars and mandibular second premolars were extracted. At the same time, a corticotomy was performed on the cortical bone of the lingual and buccal sides in the maxillary anterior as well as the mandibular anterior and posterior regions. Leveling was initiated immediately after the corticotomy. The extraction spaces were closed with conventional orthodontic force (approximately 1 N per side). The edgewise appliance was adjusted once every 2 weeks. The total treatment time was 1 year. Cephalometric superimpositions showed no anchorage loss, and panoramic radiographs showed neither significant reduction in the crest bone height nor marked apical root resorption. A corticotomy-facilitated orthodontic treatment with titanium miniplates might shorten an orthodontic treatment period without any anchorage loss or adverse effects.


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