Occurrence Of Root Resorption Research Articles

Can esthetically pleasing aligners change the root morphologies? – A narrative review

Background: The occurrence of root resorption (RR) is an unavoidable result of orthodontic treatment. Finding a straightforward approach to its prevention remains a challenge. It is a tragic occurrence when radiographically detected, even though it is rarely severe. The application of force starts a sequence of biological mechanisms. Although we are well aware of how and when it is provoked, we are unable to foresee what will happen in the end. In the past few years, clear aligner therapy has become very popular. Although not much data has been established describing RR after this treatment. Aim: The following review determines the effect of aligner therapy on the resorption of roots leading to the shortening of root length. Methods: Research publications were searched on search engines such as Scopus, PubMed, and Google Scholar using terms such as “RR,” “risk factors of RR” and “effects of clear aligner therapy on RR.” These publications were then collected. Results: For this review, 30 articles were collected and further used to formulate this review. Conclusion: (1) Most affected teeth were the maxillary central and lateral incisors post aligner therapy. (2) Multiple factors that influenced RR were gender, malocclusion, the severity of crowding, type of tooth movement, and close approximation of root toward the cortical plate (3) Clear aligner therapy is comparable to LightForce fixed orthodontics appliances but surpasses heavy-force orthodontic appliances in the terms of the risk associated with developing RR.

A scanning electron microscopical study of initial changes in human premolars teeth after orthodontic tooth movement

scanning electron microscope was used to study the effect of orthodontic tooth movement by using a force of 50 grams on the pressure side of 2l upper left premolarmt for 5- 75 days while the contralaterl side 14 teeth were used as a control. In order toruiy the morphology and occurrence of root resorptions, the organic tissue was removedrsigg sodium hypochlorite and the denuded root surface were re—examined in thescanning electron microscope. Initially, tissue affected by pressure was mainly located inhe marginal region and subsequently the mid- portion of the roots became generallyuri genced. The resorption process of cementum begins after 5 days as around cavitiesmeasuring about 4u. Further resorption in cementum was characterized by measuringsmall, thin—walled round lacunae which confluence into extensive, shallow resorptionsafter 25 days and more

Treatment Outcome and Efficiency of Aligners Compared with Conventional Fixed Appliances: A Systematic Review

Background: Over the years, aligner therapy has undergone a great evolution. The use of aligners is now an alternative to braces for aesthetic reasons. Their effectiveness and impact have yet to be evaluated. Objective: The objective of this study was to compare the effectiveness of dental movements with aligners versus the use of conventional appliances, as well as the effectiveness and impact on periodontal health and root resorption. Materials and Methods: A systematic search of PubMed, Ebsco Host and Scopus was performed using a well-designed formula. Articles published in the last 10 years in English and French were included after filtering the titles, abstracts then full texts. Results: Twenty-six records were deemed suitable for the objectives of our systematic review. All records focused on the comparison of treatment with aligners and fixed appliances. The difference in treatment and time efficiency was assessed in 17 papers, 6 papers evaluated the impact of orthodontic appliances on periodontal health, and the remaining 3 records focused on the occurrence of root resorption. Conclusion: Clear aligners produce clinically acceptable outcomes that could be comparable to fixed appliance therapy. Aligners facilitate oral hygiene practices which results in better periodontal health. However, it appears that Invisalign may not be as effective as fixed appliances in achieving certain tooth movements like vertical, radicular and rotational movements.

Pattern of Root Resorption in Luxation Injuries in Permanent Incisors Presented to Restorative Unit , Institute of Oral Health, Maharagama – Sri Lanka

The aim of this descriptive study was to evaluate the association between root resorption and each type of luxation injury, the effect of timely treatment, age of the patient at presentation and maturity of maxillary anterior teeth presented with luxation injuries. A cross sectional descriptive study was carried out on 132 patients aged 6 to 50 years old with luxation injuries occurred to 213 teeth and were followed up for 24 months. Data were collected on the age, sex, the tooth/teeth involved, type of trauma, date of occurrence of trauma and date of presentation for treatment. Radiographically teeth were assessed for the presence/absence of resorption and type of resorption (External inflammatory, external replacement and Internal inflammatory) at review appointments. Data analysis was done using the SPSS version- 24 and non- parametric tests were used assess associations. Amongst all types of luxation injuries, most frequently presented type was subluxation (40.8%) injuries followed by concussion (25.4%), Intrusive and palatal luxation (15.5% each) and extrusive luxation (2.8%) respectively. Further, 51 of 213 teeth (23.9%) showed root resorption after luxation injury. The most frequently observed resorption was external inflammatory resorption in 44 teeth (20.7%) followed by external replacement resorption in 6 teeth (2.8%) and internal inflammatory resorption in 1 tooth (0.5%). Out of 43 late presenters 77% (34) showed root resorption, while only 10% (17) of immediate presenters showed resorption of root. The results indicated that there is a statistically significant difference in occurrence of root resorption and the late presentation for treatment (X2=91.63, df=3, p=0.000), as well as with the type of injury (X2=35.9, df=12, p=0.000). Furthermore, there was a statistically significant difference between the age of the patient and the type of luxation injury (X2 =54.29, df-12, P=0.000).

Endodontics-orthodontics interrelationship: a review.

The endodontic-orthodontic interface is not well understood due to the limited scientific literature on the topic. This article aims to provide an overview of the orthodontic treatment and the risk of root resorption, the effects of orthodontic tooth movement on dental pulp and endodontically treated teeth, the role of orthodontics in endodontic-restorative treatment planning, and interdisciplinary patient management. Articles published in English from 1982 to 2021 were searched manually from google scholar using keywords ‘endodontic-orthodontic interface’ and ‘endodontic-orthodontic interrelationship’. Another search engine was MEDLINE/PubMed database using keywords ‘endodontics AND orthodontics’, ‘orthodontic tooth movement AND dental pulp’, 'orthodontic tooth movement AND endodontic treatment' and ‘orthodontics AND dental trauma’. Other relevant articles were obtained from the references of the selected papers. Alterations to the dental pulp following orthodontic tooth movement can be histologic and/or cell biological reactions as well as the increased response threshold to pulp sensibility tests. However, the occurrence of root resorption is complex and multifactorial, and can be linked to individual variation, genetic predisposition and orthodontic treatment-related factors. Endodontically treated teeth can move as readily and respond similarly to orthodontic forces as vital teeth, however with inadequate endodontic treatment, the risk of apical inflammation and bone destruction following orthodontic tooth movement is increased. Dental treatment that involves endodontic and orthodontic specialities should be carefully planned according to the individual case, taking into consideration the skills and experience of the clinicians while applying interdisciplinary patient management and available scientific data.

MANDIBULAR PLASMACYTOMA PRESENTING WITH EXTENSIVE ROOT RESORPTION

<h3>Clinical Presentation</h3> We report here an unusual case of a 67-year-old female who presented to the Faculty of Dentistry at the University of Toronto (Toronto, Canada) with a primary chief complaint of a 2-month history of dull pain in her left mandibular tooth. Clinical examination revealed percussion sensitivity and buccal palpation tenderness of the mandibular left first molar. Panoramic, intraoral, and cone beam computed tomography (CBCT) imaging showed a well-defined, irregularly shaped osteolytic lesion in the left mandibular body, with directional external root resorption of adjacent teeth. <h3>Differential Diagnosis</h3> The radiologic differential diagnosis of a well-defined osteolytic lesion resulting in extensive, directional external root resorption includes benign neoplasms and cysts. Malignant neoplasms, such as multiple myeloma, would be an unlikely consideration. In this case, the radiologic impression was of a benign neoplasm, in particular, central giant cell granuloma. Ameloblastoma and odontogenic myxoma were also considered. <h3>Diagnosis and Management</h3> A diagnosis of plasmacytoma was made through histopathologic examination. A subsequent systemic workup revealed multiple myeloma. <h3>Discussion and Conclusion</h3> Although the occurrence of root resorption in multiple myeloma is rare, it has been reported in a small number of cases in the literature. The radiologic features of this case are presented to highlight this uncommon presentation.

Intracanal dressing and root canal filling materials in tooth replantation: a literature review

The prognosis of tooth replantation is usually related to the need of endodontic treatment, which has a direct relationship with the occurrence of root resorptions. Several studies have been undertaken in an attempt to prevent, delay, or treat these complications, which are the main causes of loss of replanted teeth. This literature review examines research evidence on intracanal dressings and root canal filling materials used in cases of tooth replantation. A comprehensive search was performed in the Medline/Pubmed, Bireme and Scielo full-text electronic journal databases to retrieve English-language articles referring to these topics that had been published between 1964 and 2010. Calcium hydroxide (CH) remains the usually recommended choice as an intracanal medicament in replanted teeth; however, there is evidence to support the initial use of a corticosteroid-antibiotic combination such as Ledermix paste to control potential early resorption, prior to the introduction of CH where the beneficial effect in the treatment of progressive root resorption has been well proven. Regarding root filling materials, CH-containing sealers are a good option because of their biological properties. Accurate diagnosis and adequate treatment plan may constitute very complex tasks, particularly in tooth avulsion because several variables are involved. In addition to the technical knowledge and clinical experience directed toward the quality of treatment, patient education may favorably influence the survival of replanted teeth.

The Positive Influence of Atopy on the Prognosis of Avulsed and Replanted Teeth Despite Differences in Post-trauma Management

Introduction The aim of this study was to evaluate any potential influence of a patient’s Th2 immunologic profile on the occurrence of root resorption in avulsed and replanted teeth; tooth replantation cases in which different post-trauma management protocols were examined. Materials and Methods In this study, the presence or absence of root resorption was evaluated in 88 avulsed and replanted teeth. In the International Association of Dental Traumatology (IADT) group, the replantation technique and endodontic treatments were performed in accordance with the IADT guidelines. In the non-IADT group, the teeth were replanted using techniques and protocols that deviated from the IADT guidelines in some way. Follow-up of the replanted teeth included monthly clinical and radiographic examinations over the course of 1 year. Evaluation of patients’ atopy was based on a medical examination, personal and family allergic history, and a skin prick test. Results Of 47 teeth of atopic patients, 39 (82.98%) did not exhibit root resorption, whereas 8 (17.02%) did. Of the 41 teeth of nonatopic patients, 24 (58.54%) did not exhibit resorption, whereas 17 (41.46%) did. Conclusions These results show the importance of a predominantly Th2 immunological profile, which was represented by atopic patients, in replantation after dental avulsion despite differences in post-trauma management.

The position of maxillary canine impactions and the influenced factors to adjacent root resorption in the Korean population

The purpose of this study was to evaluate the position and aspects of maxillary canine impactions in the Korean population and investigate its comparison with the previous reports, while aiding in the establishment of diagnosis and treatment planning by revealing the influential factors of root resorption associated with such impactions. The subjects of this study consisted of 186 teeth from 148 patients, who had visited Seoul National University Dental Hospital due to impacted canines and had taken computerized tomographic images and panorama radiographic images. As a result, maxillary canine impaction in the Korean population occurred 1.5 times more often in females (F:M = 89:59) than males. Regarding the position of impaction, there were three times more buccal impactions (B:P = 140:46) than palatal impactions. The occurrence of root resorption was as high as 49.5 per cent. In evaluating the influential factors affecting adjacent root resorption, the significance of the impacted angulation was insufficient (P = 0.652). However, the buccopalatal position (P < 0.0001) and mesiodistal placement (P = 0.006, 0.037) of the impacted tooth were determined to be significant factors. Therefore, the adjacent root resorption caused by impacted maxillary canines can be stated to exhibit a greater amount of resorption as the positional proximity of the canine crown and lateral incisor root increases.

Root resorption associated with ectopically erupting maxillary permanent canines: a computed tomography study

The aims of this retrospective computed tomography (CT) study were to determine the occurrence of severe root resorption involving the pulpal canal of adjacent permanent teeth associated with ectopically erupting canines, and to verify the existence of related factors. The sample consisted of 255 consecutive patients (159 females and 96 males, mean age 18.4 and 16.8 years, respectively). Three hundred and thirty-four ectopic maxillary canines and adjacent teeth were analysed using CT images. Statistical significance was evaluated with chi-square and Fisher's exact tests. The results showed that severe root resorption of adjacent permanent teeth occurred in 17.7 per cent of ectopic canines and was equally common in females and males. Severe root resorption affected 12.6 per cent of the lateral incisors, 4.8 per cent of the first premolars, and 2.1 per cent of the central incisors. No relationship was found between the type or side of ectopic eruption, inclination of the longitudinal axis of the ectopic canine and the occurrence of severe root resorption. A significant relationship was found between a bucco-lingual position of the ectopic canine and root resorption (P < 0.05). Root resorption mainly occurred in the apical third (57.6 per cent) and apical and middle thirds (27.1 per cent). A significant relationship existed between the occurrence of root resorption and complete loss of space for the erupting canine (P < 0.05). No association was found between alignment of the upper permanent incisor and root resorption. A widened dental follicle occurred in 15 per cent of ectopic canines but did not cause root resorption of the adjacent permanent teeth. Since root resorption is asymptomatic, early detection by radiographic examination is essential for correct diagnosis and treatment.

Relationship Between Extra-Alveolar Time and Atopy in the Prognosis of the Replantation of Avulsed Teeth

The aim of this in vivo study was to evaluate the correlation between the occurrence of root resorption in avulsed and replanted teeth, extra-alveolar time, and the possible influence of Th2 immunologic profile, represented by patient's atopy and its influence in the prognosis of the tooth. This study evaluated the presence or absence of root resorption in 57 avulsed and replanted teeth. The replantation technique and endodontic treatments were performed following the International Association of Dental Trauma guidelines. Follow-up of the replanted teeth included monthly clinical and radiographic examinations during 1 year. The patient's medical examination, including the personal and family allergic history, in conjunction with the skin prick test based the evaluation of patient's atopy. Of the 37 teeth of atopic patients, 33 (89.2%) teeth did not present root resorption. Of these, 27 (72.9%) had an extra-alveolar time of <1 hour and 6 (16.2%) had an extra-alveolar time >1 hour. Four (10.8%) teeth presented root resorption and an extra-alveolar period of time >1 hour. These results showed the importance of the extra-alveolar time and the predominantly Th2 immunologic profile, represented by atopic patients, that suffered replantation after dental avulsion in a 1-year follow-up.

Endo-Orthodontics- Inside And Outside The Root - Interactions: Tasks To Be Tackled ,,

Endodontic treatment of teeth is now a common procedure across all age groups, either as a result of caries or trauma. Furthermore, as the number of adults undergoing orthodontic treatment increases, the number of orthodontic patients presenting with restored teeth or having endodontic treatment is on the rise. Diagnosis and treatment planning for these patients require an evidence based approach to achieve a good functional and esthetic results. Orthodontic treatments have profound effect on pulp and periodontal ligament which can lead to root resorption or loss of vitality which remain as orthodontic scars. Literature regarding occurrence of root resorption in vital teeth and teeth having endodontic treatment, the influence of trauma, the provision and outcome of endodontic treatment when attempted during the course of orthodontic therapy and the adjunctive role of orthodontics in facilitating good endodontic output are inconclusive till now. The integrated endodontic and orthodontic treatment in such situations will give optimum results. This article mainly focuses on orthodonticendodontic interactive tasks to be tackled that are often encountered in clinical practice which play an important role in treatment planning and its outcome.

Dental anomalies and external apical root resorption occurring during orthodontic treatment: a retrospective radiographic study of maxillary central incisor

Apical root resorption is one of the principal undesirable side effects associated with orthodontic treatment. It is provoked by a number of etiological causes, most often mechanical in nature and can be aggravated by biological factors that are not yet clearly understood. The objective of our study was to determine the influence of anomalies in dental organogenesis on the occurrence of root resorption. We analyzed the radiographs of maxillary incisors taken before and after treatment of 85 patients observed by the same practitioner. The results of our study suggest that patients with dental anomalies, anomalies of dental conformation, especially of the type of microdontia/thin root, have an increased risk of suffering from apical root resorption of maxillary central incisors during the course of orthodontic treatment.

Intrusive luxation: a case report

Intrusive luxation is one of the most severe types of dental trauma. The occurrence of pulp necrosis in intruded teeth with open apices is 100%. The risk of development of inflammatory or replacement root resorptions is high. Thus, endodontic intervention is required soon after the occurrence of trauma, in an attempt to prevent or delay the appearance of such lesions. On the other hand, the access to the root canal is difficult, as the crown is intruded. A multidisciplinary approach comprising Surgery, Orthodontics and Endodontics is required to allow exposure of the crown, orthodontic extrusion and onset of endodontic therapy. The patient GCSA, aged 15 years, attended the community project 'Lugar de dente é na boca' ('teeth should be in the mouth') of the Federal University of Goiás, Brazil, 1 week after complete intrusion of the right maxillary central incisor. Radiographic examination revealed that the incisal edge of this tooth was at the level of the crown-root interface of the adjacent teeth. After surgical exposure of the crown, pulp sensitivity was evaluated and was found to be negative. After onset of endodontic therapy, the patient was referred for orthodontic extrusion of the intruded tooth. Successive changes of root canal dressing were performed and the root canal was definitely obturated at 3 years and 6 months after onset of treatment. The present paper reports on a case of severe intrusive luxation, discusses the different treatments recommended for repositioning of traumatically intruded teeth, and questions the ideal period of maintenance of calcium hydroxide dressing in the root canal, in an attempt to prevent the occurrence of root resorption and repair any existing resorption.

Force Systems in the Initial Phase of Orthodontic Treatment—a Comparison of Different Leveling Archwires

The determination of orthodontically-effective forces and moments places great demands on the technical equipment. Many patients report severe pain after fixed appliance insertion. Since it is assumed that pain from orthodontic appliances is associated with the force and moment levels applied to the teeth and since the occurrence of root resorption is a common therapeutic side effect, it would seem important to know the actual magnitudes of the components of the active orthodontic force systems. The aim of the present study was therefore to measure initial force systems produced by different leveling arch-wires in a complete multi-bracket appliance and to assess whether force and moment levels can be regarded as biologically acceptable or not. The actual bracket position in 42 patients was transferred onto a measurement model. Forces and moments produced by a super-elastic nickel-titanium (NiTi) archwire, a 6-strand stainless steel archwire, and a 7-strand super-elastic NiTi archwire were determined experimentally on different teeth. Average forces and moments produced by the super-elastic NiTi arch wires were found to be the highest. In spite if their larger diameter, the stranded arch wires' average force and moment levels were lower, especially that of the stranded super-elastic archwire. Nevertheless, maximum force levels sometimes exceeded recommended values in the literature and must be considered as too high. The measured arch wires' initial force systems differed significantly depending on the type of archwire and its material structure. Stranded arch wires produced lower force and moment levels, and we recommend their use in the initial phase of orthodontic treatment.

Root resorption in deciduous teeth after applying orthodontic forces

The relation between orthodontic forces applied to deciduous teeth and the occurrence of root resorption, as a possible outcome of these forces, has not been studied to date. The aim of this work was to study root resorption in deciduous teeth of patients receiving orthodontic treatment. Twenty-four deciduous molars extracted for therapeutic purposes were studied: nineteen molars treated with light orthodontic forces and five untreated molars that served as control. Histological and histomorphome tric studies were performed to determine the magnitude of root resorption. Location of root resorption in treated deciduous teeth was different from that of physiological root resorption. Extent and volume of root resorption were more extensive and deeper in treated than in untreated teeth. These results suggest that radiographic follow-up of deciduous teeth subjected to orthodontic forces would be useful to prevent root fractures.

Behavior of partially formed roots of teeth submitted to orthodontic movement

The occurrence of root resorption in orthodontically treated permanent incisors with partially formed roots was investigated using periapical radiographs taken before and after the orthodontic leveling in the mixed dentition. The mean age at the beginning of treatment was 9 years and the mean treatment time was 7.1 months. The findings showed that the orthodontic movement during root formation causes no root resorption. The longitudinal follow-up showed that incompletely formed roots developed normally.

Factors affecting resorption in traumatically intruded permanent incisors in children.

There is a lack of consensus concerning the management of intruded permanent teeth. The objectives of the present study were to determine the prevalence of resorption for intruded permanent teeth and to establish the effect of factors on the timing, prevalence and rate of resorption and to examine the relationship between the timing of onset and the subsequent rate of resorption. Sixty-one intruded permanent incisors treated at the Paediatric Dentistry units in Belfast and Newcastle upon Tyne, during the period 1990-99 with a minimum follow-up period of 1.5 years, were studied. The timing and presence of resorption and its rate of occurrence over time were set as the principal outcomes. There was a significantly earlier onset and higher prevalence of resorption in more severely intruded teeth (P< 0.05). There was also a significant relationship between the degree of apical development and resorption with an increased prevalence in the more fully developed roots (P< 0.001). Resorption was detected significantly earlier in teeth with higher rates of resorption (P< 0.05). However, the treatment method did not significantly affect the prevalence or rate of resorption. In conclusion, the occurrence of root resorption after intrusive trauma appears to be related to the severity of the original injury and the stage of root development rather than the repositioning procedure.

Root resorptions in a patient with hemifacial atrophy

Hemifacial atrophy (Parry-Romberg syndrome) is a rare but well-recognized condition. The developmental effects on facial and oral structures have been well documented in the literature. However, the etiology of hemifacial atrophy remains unknown. Previous reported alterations in tooth growth and development include delayed tooth eruption, abnormal root morphology, and malocclusion but not root resorption. This report presents the orofacial changes from hemifacial atrophy in a 22-yr-old woman and describes the occurrence of root resorptions in two regions affected by this condition. The concurrent presence of root resorptions in both the maxilla and mandible in the regions showing the most severe dental malformations points to root resorption as an additional complication of hemifacial atrophy.

Scanning electron microscopy of tissue changes on the pressure surface of human premolars following tooth movement.

abstract – The pressure side of human, premolars subjected to experimental movement for 5–76 d were studied in the scanning electron microscope. Sham‐operated and untreated premolars were used as controls. In order to study the morphology and occurrence of root resorptions, the organic tissue was removed using 1:2 diamino ethane or sodium hypochlorite and the denuded root surfaces were re‐examined in the scanning electron microscope. Areas of compressed soft tissue were regularly present and the size, shape and number of such zones varied in the experimental groups. Initially, tissue affected by pressure was mainly located in the marginal region and subsequently the mid‐portion of the roots became generally influenced. Removal of hyalinized tissue started shortly after the formation, and during this soft tissue removal the underlying hard tissue was resorbed. Observation of circumferentially removed, coalesced fibers corresponded with the finding of extensively resorbed lacunae in the mineralized tissue beneath. The resorptive processes of the cementum began after 10 d as round cavities measuring about 6 μm. Further resorption in cementum was characterized by numerous small, thin‐walled round lacunae which confluenced into extensive, shallow resorptions after 20 d. Dentin was distinguished by the presence of tubules, and in sites of active resorption removal of mineral crystals had occurred, exhibiting a latticed fiber arrangement.