Evaluation of External Root Resorption of Endodontically Treated and Vital Teeth during Orthodontic Treatment: A Systematic Review

Introduction: Root resorption is the loss of apical root tissue leading to the shortness of root which is often evident in orthodontic tooth movement. Proper management during orthodontic treatment however can minimize this undesirable outcome. The present article attempts to review the etiology of root resorption, methods of diagnosis, and strategies for prevention.Materials & Method: A scoping review was done with the purpose to carry out the narrative integration of the relevant evidences on root resorption and orthodontic treatment from the published literatures. The resulting papers were studied and reviewed thoroughly for the key explanation of root resorption in orthodontic patients. A total of 41 published research articles were reviewed.Discussion: According to the literatures root resorption is common iatrogenic outcome in orthodontic treatment. Biological, mechanical, and combined biological and mechanical factors result in external root resorption. Though most clinicians diagnose root resorption by conventional radiography, researches have clearly shown that CBCT is the promising tool. The clinicians need to counsel orthodontic patients and their parents that the root resorption might be a potential consequence of the treatment lasting for long time. In case of severity; it is essential to reassess the patient and minimize the underlying cause. It is necessary to understand the role of orthodontist in preventing root resorption

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Predisposing factors to severe external root resorption associated to orthodontic treatment

Dental Press Journal of Orthodontics ◽

10.1590/s2176-94512013000100022 ◽

2013 ◽

Vol 18 (1) ◽

pp. 110-120 ◽

Cited By ~ 17

Author(s):

Gracemia Vasconcelos Picanço ◽

Karina Maria Salvatore de Freitas ◽

Rodrigo Hermont Cançado ◽

Fabricio Pinelli Valarelli ◽

Paulo Roberto Barroso Picanço ◽

...

Keyword(s):

Root Length ◽

Orthodontic Treatment ◽

Alveolar Bone ◽

Root Resorption ◽

Treatment Time ◽

Predisposing Factors ◽

Crown Root ◽

External Root Resorption ◽

Lateral Cephalograms ◽

Maxillary Incisors

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.

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Correlation Between Orthodontic Forces and Root Resorption – a Systematic Review of the Literature

Journal of Interdisciplinary Medicine ◽

10.1515/jim-2016-0033 ◽

2016 ◽

Vol 1 (2) ◽

pp. 142-145 ◽

Cited By ~ 1

Author(s):

Alexandru Vlasa ◽

Lia Yero Eremie ◽

Luminița Lazăr ◽

Anamaria Bud ◽

Mariana Păcurar ◽

...

Keyword(s):

Systematic Review ◽

Orthodontic Treatment ◽

Root Resorption ◽

Previous History ◽

Published Data ◽

High Prevalence ◽

History Of ◽

External Apical Root Resorption ◽

Orthodontic Forces ◽

Apical Displacement

Abstract Orthodontically induced external apical root resorption (OIEARR) is a major concern regarding periodontal status after nonsurgical orthodontic treatment. The aim of this study was to assess this sequel by a systematic review of published data. For assessment, we performed an electronic search of one database for comprehensive data, using keywords in different combinations: “root resorption”, “periodontics” and “nonsurgical orthodontic treatment”. We supplemented the results searching by hand in published journals and we cross-referenced with the accessed articles. Patients included in the results presented a good general health status, with no previous history of OIEARR and no other associated pathologies. Finally, twenty-three studies were selected and included in this review. A high prevalence (69–98%) and moderate severity of OIEARR (<5 mm and <1/3 from original root length) were reported. No difference in root resorption was found regarding the sex of the patients. A moderate positive correlation between treatment duration and root resorption was found. Also, a mild correlation regarding antero-posterior apical displacement and root resorption was found.

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External Root Resorption after Orthodontic Treatment with Invisalign®: A Retrospective Study

Global Journal of Health Science ◽

10.5539/gjhs.v12n11p125 ◽

2020 ◽

Vol 12 (11) ◽

pp. 125

Author(s):

Haya AlSagr ◽

Shahd AlMujel ◽

Sadeen AlShiha ◽

Najlaa AlShathri ◽

Deema AlShammary

Keyword(s):

Retrospective Study ◽

Orthodontic Treatment ◽

Root Resorption ◽

Root Apex ◽

Post Treatment ◽

Riyadh City ◽

Crown Length ◽

Anterior Teeth ◽

External Root Resorption ◽

Pre Treatment

AIM: To measure the incidence and severity of root resorption after orthodontic treatment with Invisalign. MATERIAL AND METHODS: This retrospective study was conducted at Riyadh, Saudi Arabia from June 2017 to January 2018. Pre- treatment and post-treatment Orthopantographs were obtained from orthodontic records of 29 patients managed with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA) at different dental clinics in Riyadh City. The selected sample was fulfilled the following criteria: (1) Class I malocclusion, (2) Mild to moderate crowding, (3) Non-extraction orthodontic treatment, (3) No evidence of root resorption before orthodontic treatment, (4) No root abnormalities or dilaceration, and (5) Good quality of pre- and post-treatment Orthopantographs. One examiner performed the measurements directly on the Orthopantographs using electronic digital caliper (Mitutoyo Manufacturing Co. Ltd., Tokyo, Japan) with an accuracy of 0.01mm. The measurements were performed on maxillary and mandibular central incisors, lateral incisors, and canines pre- and post-operatively, resulting in a total of 696 measurements. The crown length was measured from incisal edge to cemento- enamel-junction, while the root length from cemento-enamel-junction to root apex. RESULTS: In our study, 72% of the teeth demonstrated root resorption, in regard to the severity of root resorption, we found that mild root resorption > 0% up to 2% in all the affected teeth. Upper Anterior teeth have more significant resorption rate than lower anterior teeth P<0.05. CONCLUSION: The present study showed that incidence of root resorption was high after orthodontic treatment with Invisalign®, however the severity is very low and it is limited to the surface resorption only.

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Comprehensive orthodontic treatment in an adolescent patient with Class II Division 1 malocclusion and ankylosed maxillary central incisors

APOS Trends in Orthodontics ◽

10.25259/apos_52_2019 ◽

2019 ◽

Vol 9 ◽

pp. 190-197

Author(s):

Matthew Wen Jian Lau

Keyword(s):

Poor Prognosis ◽

Orthodontic Treatment ◽

Root Resorption ◽

Class Ii ◽

Anterior Teeth ◽

External Root Resorption ◽

Facial Esthetics ◽

Division 1 ◽

Traumatic Episode

While uncommon in orthodontics, the extraction of central incisors may be indicated when such teeth are of poor prognosis. This report details orthodontic treatment of a 13-year and 5-month-old Chinese female, who presented with Class II/1 malocclusion on a Class II skeletal jaw base relationship. Her maxillary central incisors were ankylosed and had undergone severe external root resorption following a previous traumatic episode. Orthodontic treatment involved removal of the maxillary central incisors and the mandibular first premolars. Pre-adjusted edgewise appliances with MBT prescription were used. To enhance anterior esthetics, prosthetic buildup of the four maxillary anterior teeth was performed before appliance removal. Tight intercuspation of teeth and optimal facial esthetics were achieved at appliance debond and maintained at 2-year follow-up.

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Lower Incisor Root Resorption after Orthodontic Alignment and Leveling

Journal of Health Sciences ◽

10.17921/2447-8938.2019v21n5p494-499 ◽

2019 ◽

Vol 21 (5) ◽

pp. 494-499

Author(s):

Ângela Graciela Deliga Schroder ◽

Mariana Gonzaga Erthal Ribeiro ◽

Alyssa Sales dos Santos ◽

Amaro Ilidio Vespasiano Silva ◽

Flavio Ricardo Manzi

Keyword(s):

Orthodontic Treatment ◽

Root Resorption ◽

Positive Association ◽

Time Interval ◽

Bone Maturation ◽

Lower Incisor ◽

Apical Root Resorption ◽

External Root Resorption ◽

External Apical Root Resorption ◽

Severe Degree

AbstractThe objective of this study was to evaluate the external apical root resorption in the lower incisors after orthodontic alignment and leveling using digital periapical radiographs. The sample consisted of periapical radiographs of 90 lower central incisors from 45 patients, 19 men and 26 women aged 12-36 years (mean 22.7 years). All the 90 lower central incisors were performed periapical radiographs in two phases: 1 - initial before orthodontic treatment and 2 - after alignment and dental leveling phase. The initial periapical radiographs were digitized through a transparency scanner. All patients were treated by the same orthodontist, the inclusion criteria were: never having been treated orthodontically; absence of exodontia, agenesis, malformation or defect in teeth, supernumerary teeth, endodontic treatment and impacted incisors. The time interval between the initial and post-leveling radiographs was from 6 to 12 months, with an average time of 9 months. It was observed that 47.8% of the incisors evaluated presented external apical root resorption, being most grade 1 (irregular contour up to 1 mm reabsorption). There was a positive association of external root resorption with the triangular root shape. There was no association between the severity of root resorption and the type of malocclusion. An association was observed between age and resorption severity, that is, patients who have already reached bone maturation were more likely to develop apical external root resorption. Female patients were more likely, but when men developed external root resorption, it tended to be a more severe degree. Female adult patients, with a triangular root shape, anatomical apical pipette shape, regardless of malocclusion type are more likely to develop apical external root resorption in orthodontic treatment. Keywords: Radiography, Dental, Digital. Orthodontic. Root Resorption. Resumo Esse estudo teve como objetivo avaliar a reabsorção radicular apical externa nos incisivos inferiores após alinhamento e nivelamento ortodôntico com radiografias periapicais digitais. A amostra consistiu de 90 radiografias periapicais de incisivos centrais inferiores de 45 pacientes, sendo 19 homens e 26 mulheres com idade entre 12 e 36 anos (média de 22,7 anos). As radiografias periapicais foram realizadas em dois momentos: 1 - inicial antes do tratamento ortodôntico e 2 - após fase de alinhamento e nivelamento dentário. Todas as radiografias foram digitalizadas através de um scanner de transparência. Todos os pacientes foram tratados pelo mesmo ortodontista e preenchiam os seguintes critérios de inclusão: não ter sido tratado ortodonticamente anteriormente; ausência de exodontia, agenesia, malformação ou defeito nos dentes, dentes supranumerários, tratamento endodôntico e incisivos impactados. O intervalo de tempo entre as radiografias inicial e pós-nivelamento foi de 6 a 12 meses, com tempo médio de 9 meses. Observou-se que 47,8% dos incisivos avaliados apresentaram reabsorção radicular apical externa, sendo a maioria de grau 1 (contorno irregular até reabsorção de 1 mm). Houve associação positiva da reabsorção radicular externa com a forma da raiz triangular. Não houve associação entre a gravidade da reabsorção radicular e o tipo de má oclusão. Observou-se associação entre idade e gravidade da reabsorção, ou seja, pacientes que já atingiram a maturação óssea apresentaram maior chance de desenvolver reabsorção radicular externa apical. Pacientes do sexo feminino foram mais frequentes, mas quando os homens desenvolveram reabsorção radicular externa, tenderam a ser mais graves. Um paciente adulto, do sexo feminino, com formato de raiz triangular, região apical na forma anatômica de pipeta, independentemente do tipo de má oclusão, tem maior probabilidade de desenvolver reabsorção radicular externa no tratamento ortodôntico. Palavras-chave: Radiografia Dentária Digital. Ortodontia. Reabsorção da Raiz.

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Effect of micro-osteoperforation on the rate of orthodontic tooth movement—a systematic review and a meta-analysis

European Journal of Orthodontics ◽

10.1093/ejo/cjz049 ◽

2019 ◽

Vol 42 (2) ◽

pp. 211-221 ◽

Cited By ~ 4

Author(s):

Mostafa Shahabee ◽

Hooman Shafaee ◽

Mostafa Abtahi ◽

Abdolrasoul Rangrazi ◽

Erfan Bardideh

Keyword(s):

Systematic Review ◽

Adverse Effects ◽

Orthodontic Treatment ◽

Randomized Clinical Trials ◽

Tooth Movement ◽

Root Resorption ◽

Meta Analysis ◽

Orthodontic Tooth Movement ◽

Mean Difference ◽

Canine Retraction

Abstract Background The micro-osteoperforation can be used to increase the rate of tooth movement, simplify complex orthodontic movements, and also help adjust the anchorage but there are conflicting reports on the effectiveness and adverse effects of this intervention. Objectives The aim of our systematic review and meta-analysis was to evaluate the effects of micro-osteoperforation on the rate of tooth movement in patients undergoing orthodontic treatment. Search methods A comprehensive search of MEDLINE, ISI web of science, EMBASE, Scopus, and CENTRAL online databases for studies measuring the effects of micro-osteoperforation on the rate of orthodontic tooth movement from inception to February 2019 was performed. Selection criteria Based on the PICO model, human studies which evaluated the effects of MOP on the rate of tooth movement in patients undergoing orthodontic treatment were selected for this review. Data collection and analysis The relevant data from the eligible studies were extracted using piloted custom extraction forms. The data were combined and analysed using inverse-variance random-effect meta-analysis and the mean difference was used for comparing the outcome measures. Results Six randomized clinical trials were finally included in this meta-analysis. The rate of canine retraction per month was significantly higher in the MOP group [mean difference (MD) = 0.45 mm, 95% CI = 0.17–0.74]. These results were similar with regard to different malocclusions, the jaw on which it was performed, and MOP methods. The patients did not report any significant differences in terms of pain severity levels after MOP. With regard to the adverse effects, one study reported higher amounts of root resorption among patients undergoing MOP. Conclusions The rate of tooth movement was increased after performing MOP but in at least one study higher root resorption was observed. Therefore, the use of MOP can be recommended after weighing the benefits and disadvantages this intervention can bring for each patient. Registration The protocol for this review was registered via crd.york.ac.uk/prospero with the ID CRD42019115499.

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