External apical root resorption after orthodontic treatment: Incidence, severity and risk factors.

Fatih Bayir,Esra Bolat Gumus

doi:10.34172/joddd.2021.017

Abstract

Background. This study aimed to evaluate the incidence and severity of orthodontically induced inflammatory external apical root resorption (OIIEARR) and the relationship between OIIEARR and possible risk factors such as orthodontic treatment type, treatment duration, gender, and age of the patients. A further aim was to determine the prevalence of OIIEARR in different tooth groups. Methods. The study sample consisted of 1356 orthodontically treated patients (857 females and 498 males; mean age: 14.4±2.8 years). OIIEARR was evaluated using pre- and post-treatment panoramic radiographs for all the tooth groups. Teeth with severe resorption were also assessed. Patient- and treatment-related risk factors for OIIEARR were assessed statistically using Pearson’s chi-squared test, independent-samples t test, and one-way ANOVA. Results. The incidence of severe root resorption following orthodontic treatment was 14.8%. Males exhibited a higher incidence of root resorption compared to females. Orthodontic treatment duration and treatment with extractions were positively correlated with OIIEARR (P < 0.05). OIIEARR was observed most frequently in maxillary incisors, followed by mandibular incisors. Conclusion. Orthodontic treatment with extraction, prolonged treatment duration, and large movements of the incisors should especially be taken into consideration for OIIEARR risk. Routine radiographic follow-up during orthodontic treatment is recommended.

Highlights

Orthodontics is probably the only dental specialty that uses the inflammatory process to treat functional and aesthetic problems.[1]. This inflammatory process, which is the fundamental component behind the root resorption process, is essential for orthodontic tooth movement.[1]
External apical root resorption related to orthodontic treatment is rarely serious, it is a devastating event when it is radiographically recognized
Panoramic radiographs of 211 patients in whom the roots were distorted or not clearly visualized with low image quality and eight patients with pre-treatment root resorption were excluded from the study

Summary

Introduction

Orthodontics is probably the only dental specialty that uses the inflammatory process to treat functional and aesthetic problems.[1]. Individual variations and susceptibility, which are related to this process, remain beyond our understanding.[2] Factors such as bone density and morphology, the shape of the roots, previous trauma,[3] the type of malocclusion, pre-treatment patient age,[4] patient gender,[5] the duration of active treatment,[3,6,7] orthodontic mechanics and the magnitude of force[8] and orthodontic treatment type, with or without extraction[9] have been reported as significant for the occurrence of OIIEARR. This study aimed to evaluate the incidence and severity of orthodontically induced inflammatory external apical root resorption (OIIEARR) and the relationship between OIIEARR and possible risk factors such as orthodontic treatment type, treatment duration, gender, and age of the patients. Patient- and treatment-related risk factors for OIIEARR were assessed statistically using Pearson’s chi-squared test, independent-samples t test, and one-way ANOVA. The incidence of severe root resorption following orthodontic treatment was 14.8%.

Objectives

Methods

Results

Discussion

Conclusion