Detection methods of orthodontically induced inflammatory root resorption (OIIRR): a review

Farinawati Yazid,Rohaya Megat Abdul Wahab,Yongxian Teh,Shahrul Hisham Zainal Ariffin,Asma Ashari

doi:10.21307/aoj-2020-012

Farinawati Yazid, Rohaya Megat Abdul Wahab + Show 3 more

Open Access

https://doi.org/10.21307/aoj-2020-012

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Abstract

Abstract Background Orthodontically induced inflammatory root resorption (OIIRR) is unwelcome iatrogenic damage associated with orthodontic treatment. Patients with a high risk of developing OIIRR are commonly monitored using radiographic techniques. Alternative, more sensitive methods using biological markers facilitate the early detection of OIIRR, which can minimise root surface damage and allow the timely cessation of orthodontic treatment in order to facilitate a reparative process. Aim The present review examines the current use of 2D and 3D radiographic techniques to detect and quantify OIIRR and, further, evaluates the latest literature on alternative detection methods of OIIRR. Method Published studies were searched electronically throughout PubMed, Scopus and ScienceDirect using keywords including ‘root resorption’, ‘OIIRR’, ‘radiograph’ and ‘biological markers’. Results The detection methods for OIIRR were divided into radiographic and biological marker methods. Orthopantomogram (OPG) and periapical radiography are currently the most widely used radiographic methods to detect and monitor OIIRR as they are readily available in most dental clinics, cost effective and have a relatively low radiation dose. However, the radiographic methods are not only subject to standardisation and magnification issues, but also require repeated radiation exposure to patients. Therefore, published research into the potential for biological markers as a safer and more sensitive alternative for the early detection of OIIRR was reviewed. Conclusion The result of the review highlights the potential for the use of biological markers in the early detection of OIIRR as a relatively safer and more sensitive alternative to conventional radiographic methods.

Highlights

Orthodontically-induced inflammatory root resorption (OIIRR) is defined as a complex, sterile, inflammatory process resulting from the application of forces to tooth roots, which involves bone, periodontal cells, surrounding matrix and an extensive tissue response.[1]
The most commonly used method to monitor root resorption is by the use of radiography, whereby patients at risk of Orthodontically induced inflammatory root resorption (OIIRR) are monitored with periapical or a panoramic film
The present paper examined the current literature with respect to the use of 2D and 3D radiographic techniques to evaluate OIIRR and discussed the disadvantages with respect to their accuracy, reproducibility, costs and safety

Summary

Introduction

Orthodontically-induced inflammatory root resorption (OIIRR) is defined as a complex, sterile, inflammatory process resulting from the application of forces to tooth roots, which involves bone, periodontal cells, surrounding matrix and an extensive tissue response.[1]. The commonly used radiographic methods to diagnose OIIRR have their limitations related to the superimposition of structures, magnification issues, exposing patients to ionising radiation and the inability to detect early root resorption. With these constraints of the radiographic methods, researchers have suggested the use of biomarkers as possibly a more sensitive, specific and safer alternative.[2,3] Several biomarkers released during orthodontic tooth movement (OTM) such as inflammatory cytokines, osteoprotegerin (OPG) during bone metabolism and Australasian Orthodontic Journal Volume 36 No 1 May 2020. Conclusion: The result of the review highlights the potential for the use of biological markers in the early detection of OIIRR as a relatively safer and more sensitive alternative to conventional radiographic methods. (Aust Orthod J 2020; 36: 101-107)

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