Diagnosis, Screening and Treatment of Root Resorption in Orthodontic Practices in Greece and Sweden

Abstract

Objective: To evaluate the perception of Greek and Swedish orthodontic practitioners regarding the possible occurrence and prognosis of root resorption occurring during orthodontic treatment and to estimate practitioners' approaches to the diagnosis of preexisting root resorption, screening of prevalence, and treatment planning approach when moderate or severe root resorption is present. Materials and Methods: Questionnaires were received from randomly selected Greek (n ϭ 90) and Swedish (n ϭ 106) practitioners. Topics of the questions included (a) the presence of history; (b) the radiographic evaluation of root resorption before, during, and after treatment; (c) the treatment approach of initial prevention and protocols in cases of radiographic diagnosis of root resorption during treatment. Results: Of the respondents, 47.1% of the Swedish practitioners and 32.3% of the Greek practitioners use periapical and panoramic radiographs to diagnose root resorption, mostly in the anterior region. Both groups recognize trauma, root form, and oral habits as predisposing factors. The majority of Swedish orthodontists perform radiographic follow-up in the first 6 months. In contrast, the Greek orthodontists perform it at 1 year or at the end of treatment. The treatment approach for root resorption that is most frequently used by Swedish orthodontists is altering the treatment plan, using light forces, and allowing resting periods, while the Greek orthodontists most frequently use lighter forces and reduce the total duration of the treatment. Conclusions: Because there is no specific approach offered in the literature, the prevention and treatment reassessment in cases of root resorption relies on individual practitioner perception.

CBCT assessment of mandibular incisor orthodontically induced root resorption during accelerated tooth movement via low level Laser therapy

“…24 Usually, two-dimensional radiographic (2D) methods as periapical or panoramic radiographs are obtained before, during, and after orthodontic treatment to record OIRR. 25 Studies using 2D imaging techniques revealed OIRR to be less than 0.60 mm at the end of treatment. 26 However, OIRR affects all aspect of the root surface in 3D therefore, 2D radiographs might mask the true degree of OIRR.…”

Endodontic–orthodontic interactions: a review and treatment recommendations

“…It has been established that the management of OIIRR related to OTM does not have definitive guidelines and there are global differences and similarities in clinical approaches 138,139 . There appears to be similar confusion amongst clinicians concerning the orthodontic management of traumatized teeth 140–143 .…”

“…It has been established that the management of OIIRR related to OTM does not have definitive guidelines and there are global differences and similarities in clinical approaches. 138,139 There appears to be similar confusion amongst clinicians concerning the orthodontic management of traumatized teeth. [140][141][142][143] Previous recommendations have been published concerning waiting periods prior to OTM for traumatized teeth, [56][57][58]144,145 but these were often based on the same literature.…”

Evaluation of Risk Factors for Severe Apical Root Resorption in the Maxillary Incisors Following Fixed Orthodontic Treatment

“…Clinical examination is not reliable as clinical symptoms are almost absent, and increased tooth mobility is seen only in extremely severe cases with additional alveolar bone loss resulting through time (Jönsson et al, 2007). Moreover, EARR is being monitored before, during, and after orthodontic treatment usually by using two-dimensional radiographic (2D) methods like periapical or panoramic radiographs (OPT) (Makedonas and Hansen, 2008). However, apical root resorption occurring after orthodontic tooth movement is usually underestimated when evaluated on panoramic radiographs (Dudic et al, 2009) (Picture 4.7.5.1).…”