External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation

Abstract

PurposeThis study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption.Materials and MethodsThe records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption.ResultsThe periapical radiographs of 564 teeth showed that the average root resorption was 1.39±1.27 (8.24±7.22%) and 1.69±1.14 mm (10.16±6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket.ConclusionThese results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

Penyerapan Akar Gigi Apeks Luaran Hasil Rawatan Ortodontik Pada Enam dan 12 Bulan

“…Perkaitan antara keterukan penyerapan akar gigi pada bulan keenam dan 12 rawatan ortodontik membolehkan pengenalpastian awal terhadap risiko penyerapan akar yang lebih teruk pada seseorang individu (Artun et al 2005). Terdapat beberapa faktor berlakunya PAAL yang didorong oleh rawatan ortodontik dan ia terdiri daripada faktor variasi biologi dan faktor rawatan itu sendiri seperti morfologi akar gigi (Sameshima & Sinclair 2001), genetik (Al-Qawasmi et al 2003), sejarah trauma (Linge & Linge 1991;Nanekrungsan et al 2012), jangka masa rawatan dan magnitud daya ortodontik yang dikenakan (Fox 2005;Levander & Malmgren 1988).…”

“…Pengaruh sejarah trauma pergigian terhadap penyerapan akar gigi semasa rawatan ortodontik telah lama dikaji (Brin et al 2003;Linge & Linge 1991, 1983Mandall et al 2006;Nanekrungsan et al 2012). Walau bagaimanapun, perbezaan teknik pengukuran antara kajian terdahulu menyebabkan kesukaran dalam membandingkan kekerapan dan keterukan PAAL.…”

“…Keterukan yang lebih tinggi pada penyerapan akar gigi trauma dapat diperhatikan dalam kajian Linge dan Linge (1983) telah pengukuran dilakukan pada penghujung rawatan ortodontik (purata 3.6 tahun) menggunakan radiograf periapeks, manakala dalam kajian ini pengukuran penyerapan akar gigi dilakukan pada peringkat awal rawatan ortodontik iaitu enam dan 12 bulan menggunakan imej CBCT yang terhasil merupakan pendekatan yang lebih tepat kerana mempunyai resolusi yang lebih baik berbanding imej periapeks. Nanekrungsan et al (2012) mengkaji faktor berkaitan dengan PAAL termasuklah trauma dan terdapat perbezaan yang signifikan (p<0.05) pada peratus PAAL antara gigi yang mempunyai sejarah trauma (25 batang; 14.75%) dan gigi tanpa trauma (539 batang; 8.07%) pada penghujung rawatan ortodontik. Sebaliknya, dalam kajian ini, purata penyerapan akar gigi bagi kumpulan trauma dan tanpa trauma tidak menunjukkan perbezaan yang signifikan (p>0.05) pada enam (X 6 ) dan 12 (X 12 ) bulan rawatan ortodontik (Jadual 3).…”

Physical properties of root cementum: Part 25. Extent of root resorption after the application of light and heavy buccopalatal jiggling forces for 12 weeks: A microcomputed tomography study

“…Duration of treatment and horizontal (but not vertical) displacement of the incisor apices also affected proportionately root resorption, but no differences were found for slot size, archwire type, elastics, and types of expansion. 21,26 As far as biomechanical factors of orthodontic forces are concerned, human studies have shown that increased root torque, tip, and rotational movements result in greater root resorption. [29][30][31] The effects of jiggling forces on root resorption were investigated in animal studies.…”

“…9 Both patient-related factors and orthodontic treatmentrelated factors have been reported to contribute to the degree and the severity of OIIRR. Previous investigations have linked the severity of root resorption to various factors, including type of orthodontic appliance, [10][11][12] magnitude of applied force, 2,13-16 duration of force application, [17][18][19][20][21] type of tooth movement, 2,11,12,19,22 clinical factors, 21 systemic factors, 23 patient age, [24][25][26] genetic factors related to root anomalies, 27 previous trauma, 11,12 and ethnicity. 21 Pretreatment factors were evaluated in the patients' records to help clinicians predict the incidence, location, and severity of root resorption before the orthodontic treatment.…”