Effect of apical root resorption on periodontal support

Apical Root Resorption after Lingual Orthodontic Therapy

“…Therefore studies based on a larger sample use only radiological methods, although this involves some limitations. The radiologic assessment of apical defects can be based on panoramic radiographs [12] or periapical x-rays taken in the right-angle or long-cone paralleling technique [4]. According to Göz & Rakosi [11], direct metric analyses of panoramic radiographs are not recommended due to lack of reproducibility.…”

“…This raises the question of the clinical relevance of root resorptions. Kalkwarf et al [12] emphasized that a 3 mm loss of apical tissue corresponds to a 1 mm loss at the alveolar margin, i.e. damage to the periodontal ligament through periodontal diseases has much more serious consequences than apical resorptions.…”

Root Resorption in Orthodontics

“…While Jacobson (6) stated that a 1-mm loss in the apex is not important because the apical region has the smallest diameter in a tooth, Kalkwarf et al (7) mentioned that there can be an important relationship between the length of the root and periodontal connection; thus, even the smallest loss in the root can be significant.…”

Risks and Complications Associated with Orthodontic Treatment

“…If in the end of the treatment the root resorption's severity is mild or moderate the tooth prognosis doesn't greatly decrease. Kalkwarf demonstrated that 4 mm root shortening due to this pathological aspect is equivalent to 20% loss of the periodontal attachment, and 3 mm loss equivalent to 1 mm loss of the periodontal attachment (Kalkwarf et al, 1986). The high severity forms of root resorption, corresponding to considerable root shortening with influence on tooth prognosis, are one of the most discussed complications in association with the orthodontic therapy, being perceived as an unpredictable consequence with insufficient knowledge about its treatment alternatives and evolution.…”