Abstract
This study aims to critically evaluate orthodontically induced external apical root resorption (OIEARR) in incisors of patients undergoing non-surgical orthodontic treatment of class II division 1 malocclusion by a systematic review of the published data. An electronic search of two databases was performed; the bibliographies of relevant articles were also reviewed. Studies were included if they examined the amount of OIEARR in incisors produced during non-surgical orthodontic treatment of individuals with class II division I malocclusion in the permanent dentition. Individuals had no previous history of OIEARR, syndromes, pathologies, or general diseases. Study selections, risk of bias assessment, and data extraction were performed in duplicate. Eight studies of moderate methodological quality were finally included. An increased prevalence (65.6% to 98.1%) and mild to moderate severity of OIEARR (<4 mm and <1/3 original root) were reported. No sex difference in root resorption was found. For the maxillary incisors, there was no evidence that either the central or lateral incisor was more susceptible to OIEARR. A weak to moderate positive correlation between treatment duration and root resorption, and anteroposterior apical displacement and root resorption was found. Current limited evidence suggests that non-surgical comprehensive orthodontic treatment to correct class II division 1 malocclusions causes increased prevalence and severity of OIEARR the more the incisor roots are displaced and the longer this movement takes.
Highlights
Induced external apical root resorption (OIEARR) is a relatively common iatrogenic problem that has challenged orthodontists for many years
Histologic studies have reported greater than 90% occurrence of Orthodontically induced external apical root resorption (OIEARR) [1,2,3,4], whereas radiographic evaluation studies reported between 48% and 66% occurrence [5,6,7,8]
OIEARR is usually less than 2.5 mm [9,10,11,12] when assessed by panoramic or periapical radiographs and is typically classified as mild to moderate with minor clinical significance
Summary
Induced external apical root resorption (OIEARR) is a relatively common iatrogenic problem that has challenged orthodontists for many years. The etiology of OIEARR is unclear with various studies reporting 7% to 15% of untreated patients present with non-orthodontically induced external apical root resorption prior to orthodontic treatment [5,17]. Individuals vary in their susceptibility to OIEARR with various factors such as tooth root morphology [10], length [10], genetics [18], and chronological age [19]. There are a number of reported orthodontic treatment-related risk factors suggested in the literature such as treatment duration [13,20], magnitude of applied force [4], and amount of apical movement [20]
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