Abstract
Cervical root resorption is an uncommon, aggressive form of external resorption that occurs on the root surface of a permanent tooth and presents clinically as a characteristic pinkish discoloration of the tooth. The cause of cervical root resorption is poorly understood, and it has been suggested that orthodontic treatment may play a role in causing this pathological condition. The aim of this systematic review was to investigate whether orthodontic treatment could be considered as a risk factor of cervical root resorption in patients who had undergone fixed appliances therapy. A comprehensive electronic and manual search was conducted in four databases and six journals without any limitations on year of publication. A customized data extraction form was used to retrieve relevant information from each eligible study. Risk of bias was assessed using the Cochrane risk of bias tool (RoB 2) and the risk of bias in nonrandomized studies of interventions tool (ROBINS-I). The quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluation (GRADE) approach. Two randomized clinical trials (RCTs) and one cohort study were included in the review. Risk of bias was assessed as high for both RCTs and critical for the cohort study. Conflicting results were reported by the studies included in this review. Both RCTs reported significant differences between orthodontically moved teeth and teeth that were not moved, while the cohort study reported a lack of association between fixed orthodontic treatment and cervical root resorption. Quality of evidence provided by this review was judged to be of very low quality. Orthodontic treatment may have potential in inducing cervical root resorption; however, due to the high risk of bias of the included studies and their conflicting findings, better-quality studies are needed to make definitive conclusions.
Highlights
Root resorption is a condition that occurs when there is a partial loss of cementum and dentin
If this inflammatory resorption is seen on the inner wall of the root canal, it is known as internal resorption, whereas if it was on the external surface of the root, it is called external resorption.[2]
After further inspection of the full texts of these articles, 23 were excluded for various reasons as follows: 8 were reviews; 8 were case reports or series; and 7 articles were excluded for other reasons including the lack of information from the abstract alone, the inclusion of endodontically treated teeth, not all patients receiving orthodontic treatment, or because the study was more focused on general risk factors of cervical root resorption rather than the risk of cervical root resorption in relation to an orthodontic treatment
Summary
Root resorption is a condition that occurs when there is a partial loss of cementum and dentin. External inflammatory resorption, transient apical breakdown, and external cervical resorption.[3] External cervical resorption can be referred to by many clinical terms including invasive cervical resorption, peripheral cervical resorption, subepithelial external root resorption, and cervical root resorption.[4,5,6,7] Due to its many names, this type of external resorption will be referred to as cervical root resorption throughout this study to avoid any confusion
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