A wide array of variables have been suggested as predisposing factors to this resorption. Etiology and sequelae of root resorption seminars in. Root resorption is a physiologic or pathologic process occuring as a result of changes seen in the tooth or surrounding periradicular tissues characterized by loss of tooth structure over the root surface. Mar 03, 2014 root resorption in orthodontics certified fixed orthodontic courses by indian dental academy 1. An evaluation of apical root resorption after orthodontic. Its etiology is multifactorial and may be associated with individual biological variability, genetic predisposition, effect of mechanical factors, root morphology, and tooth injuries sustained before orthodontic treatment. The search was carried out by using a combined text and the mesh search strategies. Recent research has focused more on the cause and effect relationship as well as preventive or treatment options to combat this unwelcome event. A comparison of root resorption between invisalign treatment. It is also clear that root shortening is a common case in families. When this happens, a number of questions about the cause of such resorption and the appropriate treatment arise in the dentists mind. The aim of the study was to investigate the incidence and severity of rr in adult patients treated with. Clinical management of severe external root resorption. The prevalence of apical root resorption arr in patients with clear aligners is still controversial.
A number of treatmentrelated factors have been implicated in the pathogenesis of root resorption in orthodontic patients. Orthodontic root resorption of endodontically treated teeth tarso esteves, dds, adilson luiz ramos, phd, calliandra moura pereira, dds, and mirian marubayashi hidalgo, phd abstract the purpose of this study was to evaluate, radiographically, whether there is similarity in the apical root resorption found in endodontically treated teeth and. Root resorption associated with orthodontics brampton. Root resorption after orthodontic treatment is surface resorption. Apical root resorption under orthodontic therapy the. An overview and case report of endodontic management. Apical root resorption caused by orthodontic forces. External apical root resorption caused by orthodontic treatment. Root resorption after root canal beverly hills root resorption treatment. Review articles and relevant articles were searched for crossreferences. Orthodontically induced inflammatory root resorption oiirr or, as it is better known, root resorption, is an unavoidable pathologic consequence of orthodontic tooth movement. Apical root resorption may occur after orthodontic tooth movement. Etiology root resorption can be initiated by many factors acting alone or simultaneously. Occlusiontmd, orthodontics blunting or shortening of the roots of teeth that have been moved orthodontically is commonly seen.
Root resorption is a common side effect of orthodontic treatment. Evaluation of the risk of root resorption during orthodontic treatment. Root resorption rr is a permanent loss of tooth structure from the root apex. If left untreated, it can result in the progressive destruction of intraradicular dentine and dentinal tubules along the middle and apical thirds of the canal walls as a. A comparison of root resorption between invisalign treatment and contemporary orthodontic treatment. Root resorption, earr, orthodontics, genetics, heritability. In most cases, it is so insignificant that it is hardlyif at allnoticeable on successive xrays. Surface resorption is a selflimiting process, usually involving small outlining areas followed by spontaneous repair from adjacent intact parts of the periodontal ligament. Concerns in the orthodontic community include reliable diagnostic methods to improve how we predict, prevent andor manage root resorption. May 15, 2017 root resorption rr is described as a permanent loss of tooth structure from the root apex. Orthodontic treatment in patient with idiopathic root. Root resorption detectable histologically is a preliminary step toward exter nal apical root resorption earr that is perma nent and detectable radiographically. The application of removable aligner in orthodontic treatment has increased rapidly in recent years, while its effects on root resorption remains unclear.
How to prevent root resorption using the golden rule of. The aim of this metaanalysis was to investigate the effect of orthodontic treatment on root resorption of endodontically treated teeth compared to vital teeth. Several authors demonstrated that rr occurs even without orthodontic treatment 3,4,5,6, but patients who underwent orthodontic treatment are. Radiographic examination of orthodontically treated patients shows some loss of root length in 48 per cent remington et al. In total, 10 sprague dawley rats were randomly allocated into the experimental group eg and control group cg. I noticed root resorption in two children and after having a look at the records of their mother, i realized she had the same problem. Detection of apical root resorption after orthodontic. There are several types of external root resorption with the most common being external inflammatory root resorption. The aim of this study was to investigate and compare the prevalence and severity of arr in patients treated with clear aligners and fixed. Pdf apical root resorption caused by orthodontic forces. The aim of this study, therefore, was to compare root resorption after the application of intrusive and ex. Apical root resorption after orthodontic treatment apical root resorption after orthodontic treatment.
By combining the results from clinical trials, we believed that a stronger evidencebased approach to rr associated with orthodontic tooth movement would provide important guidelines for contemporary clinical practice. Moreover, to our knowledge, no studies exist comparing root resorption after the application of continuous extrusive and intrusive forces in the same individual. Root resorption in orthodontics is referred to as induced inflammatory resorption, and it is a form of pathological root resorption, in which orthodontic forces are transferred to the teeth and hyalinized areas are thus removed in the periodontal area. It occurs the patients are genetically vulnerable to root resorption. One problem that can shorten the life of your teeth is root resorption, which is a breakdown or destruction of the root of a tooth or teeth. Apical resorption, endodontics, orthodontic treatment, root resorption a pical root resorption, normally characterized by apical rounding, is a common event in orthodontic treatment 18. The aim of this study was to comparatively evaluate the amount of external apical root resorption earr in nonextraction patients receiving clear aligner therapy cat or fixed orthodontic. In orthodontics, induced inflammatory root resorption is a form of pathologic root resorption related to the removal of hyalinized areas of the periodontal ligament following. This is a normal physiological process in the exfoliation of the primary dentition, caused by osteoclast differentiation due to pressure exerted by the erupting permanent tooth. Harry and sims 1982 found that some level of root resorption existed in most patients. External apical root resorption in nonextraction cases. The most common cause of external root resorption is trauma particularly in cases where the injury results in pulpal necrosis and damage to the root surface, leaving. Phillips 1955 apical root resorption under orthodontic therapy.
Root resorption is a relatively common sequel of orthodontic treatment. Their impact on clinical dental practice vincent g. Resorption can be defined as a condition associated with either a physiologic or a pathologic process resulting in a loss of dentin, cementum andor bone. By my signature below i acknowledge that i have read the orthodontic informed consent and notice of privacy practice and may receive a. It may arise as a sequela of traumatic injuy, orthodontic tooth movement, or chronic infection of the pulp or periodontal. Pdf root resorption in relation to orthodontic tooth. Apical root resorption in upper anterior teeth european. The odontoclasts are responsible for root resorption and the process of. External apical root resorption following orthodontic. Following root resorption there is repair by cellular cementum, but factors mediating the transition from resorption to repair are not clear. Genetic factors in external apical root resorption and. Factors related to apical root resorption of maxillary. It was expected that variables relating orthodontic treatment to rr would be identified.
Analysis of predictors of root resorption in orthodontic. External apical root resorption caused by orthodontic. Incisor root resorption due to ectopic maxillary canines. Pdf root resorption associated with orthodontic tooth. Occasionally, general dentists are challenged with providing restorative treatment for a postorthodontic patient who has had moderate to severe root resorption. In orthodontics, induced inflammatory root resorption is a form of pathologic root resorption related to the removal of hyalinized areas of the periodontal ligament following the application of orthodontic forces and is considered an undesirable but unavoidable. Apical root resorption after orthodontic treatment pdf. Many factors have been investigated to explain differences seen among individuals in their susceptibility to earr. In teeth with complete root formation, the surgical or orthodontic repositioning must be adopted as soon as possible, together with the endodontic treatment with calcium.
Root resorption is a common outcome of orthodontic treatment. Orthodontically induced inflammatory root resorption is unaffected by archwire sequencing, bracket prescription, and selfligation. In this article, i will discuss the firstroot resorption. Dental trauma and root resorption, principles in contemporary orthodontics, silvano naretto, intechopen, doi. An aao survey revealed that root resorption was considered a very important clinical issue by 60 percent of participating orthodontists. Prevalence and severity of apical root resorption during. Consequences range from slight tooth mobility resulting from mild amounts of root resorption to complete loss of teeth due to excessive root resorption. Orthodontic root resorption of endodontically treated teeth. Demas will evaluate each individual tooth and any movement of the tooth through the use of xrays. If your family has a history of root resorption the team at fry orthodontics will formulate a treatment plan that works best for you.
Root resorption after orthodontic intrusion and extrusion. Left periapical radiograph of tooth with external inflammatory root resorption showing radiolucent areas on the root and the alveolar bone. External apical root resorption arr is a common iatrogenic consequence of orthodontic treatment. External apical root resorption earr of permanent teeth is uncommon but a frequent sequelae to orthodontic tooth movement. Root resorption can occur at any time during orthodontic treatment and lead to a compromise in the prognosis of the tooth and the stability of the treatment results. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Many reports in the literature indicate that orthodontically treated patients are more likely to have severe apical root shortening, interesting mostly maxillary, followed by mandibular incisors. Severe root resorption resulting from orthodontic treatment. Root resorption after root canal beverly hills root. External apical root resorption earr is a common clinical complication of orthodontic treatment. Indian dental academy leader in continuing dental education 2. The aim of this clinical and confocal laser scanning microscopic study was to compare the effects of two frequently used archwires on tooth movement and root resorption. The effect of orthodontic therapy on periodontal health. We all hope that our teeth will last a lifetime but many of us know that this is not often the case.
The bas1c premise of orthodontic treatment is that when force is applied to a tooth there is resorptron of bone in the region of pressure and bone formation takes place in the side of tension. Orthodontic treatment of cases in which an ectopically positioned maxillary canine is complicated by associated resorption of an incisor root varies according to such individual factors as the position of the canine, lack of space and guidance, developmental stages of neighboring teeth, and site and severity of the root resorption. Apical root resorption after orthodontic treatmenta. Root resorption established in cbct research was less serious and more accurate than that observed in the twodimensional research. However, some individuals may experience noticeable resorption of their. Root resorption of endodontically treated teeth following.
Braces and root resorption invisalign root shortening braces. Root resorption figure 1, or shortening of the roots, occurs in almost every case of orthodontic tooth movement. A literature search was conducted in 18 electronic databases. Belinda weltman hbsc, ms, dmd, bdent, msc, frcdc root resorption. In other words, it runs in the family, but minor root shortening usually isnt a cause for concern like traumainduced resorption. Root resorption root resorption can be classified into at least 3 categories. Its clinical outcomes in orthodontic patients are highly variable and depend on genetic predisposition, individual biologic variability, and mechanical factors. Orthodontic treatment has been associated with apical root resorption for many years, but a consensus on treatmentrelated causes of apical resorption cannot be found in the literature. Root resorption before and after orthodontic treatment. The aim of this investigation was to study the reparative potential of orthodontically induced root resorption. A case report diego rey1, rosana martinez smit2, liliana gamboa3. It is the permanent shortening of the end of the tooth root that can be seen on routine dental radiographs. Risk factors of root resorption after orthodontic treatment.
Because severe root resorption, when it occurs in orthodontic patients, is an iatrogenic consequence of. Root resorption has been defined as the loss of dental hard tissue as a result of osteoclastic cell action 1 and can occur on both external and internal surfaces. It is destruction of the cementum or dentin by cementoclastic or osteoclastic activity. Stability and prognosis of teeth with severe root resorption is problematic in orthodontics. Most resorption is clinically insignificant, but, if severe, root resorption threatens the longevity of the teeth. In addition to the overjet and overbite, this study analyzed the correlation between the occurrence of root resorption after orthodontic treatment with age, gender and presence or not of endodontic treatment. Internal root resorption is usually asymptomatic and identified by chance on routine radiographic examination. Factors related to apical root resorption of maxillary incisors in orthodontic patients kirsten nigul, triin jagomagi summary the main objective of the study was to determine the extent of external apical root resorption at the end of orthodontic treatment and to identify the possible pretreatment and treatment factors that would. Root resorption in orthodontics certified fixed orthodontic. When the root looses apical material beneath the cementum, no regeneration is possible and the resorption is irreversible. If left untreated, it can result in the progressive destruction of intraradicular dentine and dentinal tubules along the middle and apical thirds of the canal walls as a result of clastic activities. Tridimensional resorption of the hard tissue components of the root apex occurs, and root shortening is evident. A total of 84 premolars in 27 individuals 10 boys, 17 girls, with a mean age of 12.
Dental trauma and root resorption 239 happen, orthodontic repositioning is indicated, observing the pulp vitality kinirons, 1998. S, professor and head, department of orthodontics and dentofacial orthopaedics, terna dental college and hospital, mumbai, india, 2m. One of the aims of this article is to present a brief overview of the literature, including. In a split mouth experimental design the premolar on one side. Current evidence suggests that root length and volume were reduced after orthodontic treatment. Sep 10, 2016 internal root resorption is usually asymptomatic and identified by chance on routine radiographic examination. There were different degrees of root resorption after orthodontics, but it was clinically acceptable. External apical root resorption earr is a frequent clinical complication secondary to orthodontic tooth movement. Tooth resorption, or root resorption, is the progressive loss of dentine and cementum by the action of osteoclasts. Prevalence and severity of apical root resorption and alveolar bone loss in orthodontically treated adults. Sixtyfour maxillary right and left first premolars in 32 patients 15 boys and 17.
Evidence suggests that comprehensive orthodontic treatment causes increased incidence and severity of root resorption, and heavy forces might be particularly harmful. External root resorption occurs on the outer surface of the root, and the causes for this may vary. Fixed appliances have been the mainstream for orthodontic treatment, while clear aligners, such as invisalign system, have become increasingly popular. S, professor and head, department of orthodontics and. In the current study, lithium chloride licl, a wnt signaling activator, was examined to determine its effect on root resorption. Root resorption in orthodontics bone is the only tissue that should ideally get resorbed under the apphcaffon of orthodontic forces. Root shortening as a result of apical root resorption is an undesirable consequence of orthodontic treatment. Root resorption certified fixed orthodontic courses by. Root resorption during orthodontic treatment with invisalign. August 2008 journal of dental education 895 orthodontic and nonorthodontic root resorption. Root resorption a physiologic or pathologic process occurring as a result of changes seen in the tooth or surrounding periradicular tissues characterized by loss of tooth structure over the root surface type physiologic root resorption. External root resorption after orthodontic treatment. Nov 19, 20 to assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment.
Root resorption or shortening of the roots occurs in nearly all cases of orthodontics, but is so insignificant that it may not be possible to see it on an x ray. Jul 31, 2017 many teeth that are experiencing root resorption still function quite normally. Root resorption diagnosis, classification and treatment. Frequency of root resorption following trauma endodontic. A comparison of root resorption between invisalign. This article will describe the orthodontic and restorative management of three patients with. Murine molars have 5 roots,3,5,12 and the experimental orthodontic.
Surface resorption occurs constantly as microdefects on all roots. The incidence and extent of apical root resorption in maxillary incisors were studied radiographically in 719 consecutively treated orthodontic patients. Braces and root resorption team demas orthodontics. Apical external root resorption and repair in orthodontic.
Earr and rr during orthodontic tooth movement are related conditions in. The effect of orthodontic treatment on the dental pulp and its role in root resorption, the influence of previous trauma to the tooth and endodontic treatment in orthodontic tooth movements and root resorption, recommendations regarding endodontic treatment during orthodontic tooth movement and the role of the orthodontic forces in provision. In ankylotic root resorption, there is no known stimulation factor. Frequency of root resorption following trauma to permanent teeth.
What we know and how it affects our clinical practice. Pdf root resorption is an undesirable sequela of orthodontic tooth movement. Longer orthodontic treatment may result in greater. Mar 06, 2014 during routine treatment, root shorting occurs among 2% of the patients. This type of resorption is considered by several authors to be unique in its etiology and presentation compared to other resorptive lesions10,1216 and has been assigned a subset classification. Root resorption in a few cases, the ends of some of the teeth are shortened during. Interrelationships of endodontic orthodontic treatments. Root resorption associated with orthodontic tooth movement. An evaluation of external apical root resorption after orthodontic treatment elizabeth thomas a research report submitted to the faculty of health sciences, university of the witwatersrand, johannesburg, in partial fulfillment of the requirements for the degree of master of science in dentistry. The last type of resorption that well discuss is that which occurs during orthodontic tooth movement.
External apical root resorption is one of the most common iatrogenic sequelae of orthodontic treatment. Maxillary central incisor was the most resorbed tooth, followed by the maxillary lateral incisor, the mandi. Apr 20, 2017 these changes may occur in patients who have a genetic history of root resorption. Pdf constant versus dissipating forces in orthodontics. Root resorption is a condition associated with either a physiologic or a pathologic process resulting in a loss of dentin, cementum andor bone it may be initiated in the periodontium and affect initially the external surfaces of the tooth external resorption or it may start within the pulp space affecting primarily the. A tooth can function for a considerable number of years or a lifetime despite root resorption. Longterm evaluation of apical root resorption after. An increase in rr can be accomplished with increased duration of orthodontic force application and force, with the higher magnitude of moments. Orthodontics and external apical root resorption shaza k. External root resorption with the selfligating damon systema retrospective study.