Association of Orthodontic Clear Aligners with Root Resorption Using Three-dimension Measurements: A Systematic Review

Abstract

Aim: This paper aims to assess the evidence in the literature reporting orthodontically induced inflammatory root resorption (OIIRR) in treatment with orthodontic clear aligners using 3D measurements. Materials and methods: Following preferred reporting Items for systematic reviews (PRISMA) statement, eight electronic databases were searched for relevant published and unpublished records. Data collected according to restricted inclusion and exclusion criteria. Results: A total of 236 articles were identified as relevant to our topic. Duplicates were excluded resulting in 226 papers, out of which 31 papers were relevant after screening titles and abstracts. Only 2 high-level evidence papers out of the 31 met the inclusion criteria for the qualitative synthesis. Conclusion: Based on the available studies with high level of evidence in the literature, we conclude that orthodontic clear aligners are non-inferior to light-force fixed orthodontic appliances, and superior to heavy-force fixed orthodontic appliances in terms of the risk for developing apical root resorption. Clinical significance: Orthodontists can be more assured about the low-risk of OIIRR associated with clear aligners compared to other orthodontic treatment modalities, and it remains up to the practitioner's assessment to select the appropriate treatment on a case by case basis.

Orthodontic treatment with clear aligners for a patient with chronic periodontitis

“…10 , 11 Compared with conventional fixed appliances, clear aligners are a better choice for patients with periodontal disease because of their ease of oral hygiene maintenance, precise control of force, and mandibular incidence of root resorption. 12 - 14 This case report demonstrates the successful orthodontic treatment of a 24-year-old woman having inactive periodontitis with clear aligners.…”

Root resorption factors associated with orthodontic treatment with fixed appliances: A systematic review and meta-analysis

“…73 Aldeeri et al performed a systematic review that aimed to evaluate the evidence concerning EARR in CAT during orthodontic treatment. 74 They reported a low risk of EARR associated with CAT. However, due to the design and quality of the included studies, solid evidence could not be established.…”

External Root Resorption (ERR) after orthodontic treatment: Review article

“…However, certain current protocols for the use of fixed apparatus usually involve the proper and sequential use of light forces, therefore the predisposition to develop ERR is similar to removable alienators [1]. However, Jyotirmay et al and Adeeri A et al, conclude that the rate of root resorption is lower in those patients who undergo treatment with transparent aligners compared to conventional fixed apparatus [14,15]. In a similar way, Mohamed H et al, describe that the use of transparent alienators probably does not reduce the incidence of ERR at all, but being correctly employed together with a collaborative and disciplined patient, the risk of developing this abnormality can be significantly reduced [16].…”