Root resorption in orthodontic treatment with clear aligners: A systematic review and meta‐analysis

Abstract

The aim of this study was to investigate the external root resorption in participants receiving clear aligners and compare it with those treated with fixed appliances. Systematic review with meta‐analysis. Electronic and manual search were performed, and specific inclusion and exclusion criteria were used. Data extraction and analysis were conducted by two investigators independently. The original outcome underwent statistical pooling by Review Manager 5. The quality of studies was assessed by ROBINS‐I tool. A total of 11 studies were included for qualitative analysis (six in moderate risk of bias while another five in serious risk of bias), and three of them were statistically pooled in meta‐analysis. The external root resorption in treatment with clear aligners was significantly lower than that with fixed appliances (SMD = −0.65, 95% CI [−0.74, −0.55], P < .01). Subgroup analysis on each quadrant of incisors was consistent with the former result. Current evidences suggest that clear aligners might not avoid root resorption, but the incidence and severity of resorption could both be lower compared with results reported by treatment with fixed appliances.

Reabsorción radicular externa asociada al tratamiento ortodóncico: revisión de la literatura

“…Respecto a los factores de riesgo asociados al tratamiento ortodóncico, una magnitud de fuerza mayor a 150 gr/cm 2 induce significativamente un mayor riesgo de sufrir RRE que las fuerzas ligeras 3,4,7,11,18,22,24,27,28,29 . Las fuerzas continuas y/o controladas, que se activan cada 4 semanas que permiten la recuperación biológica, generan menos reabsorción en comparación con las fuerzas intermitentes y/o descontroladas propiciadas por ejemplo por aparatos removibles 3,4,7,9,11,14,17,18,22,23,28 .…”

“…Los alineadores removibles (invisalign) no generan mayor predisposición a este fenómeno en comparación con la aparatología fija, esto puede deberse a que los protocolos actuales del uso de aparatología fija usa fuerzas ligeras en cada paso 11,16,29,32 , Fang y colaboradores exponen que si existe la colaboración del paciente y un tratamiento bien diseñado por parte del ortodoncista (alineadores removibles), se pueden predecir los movimientos, evitando movimientos repetidos y reduciendo la posibilidad de que se produzca esta complicación al ser comparada con la aparatología fija 27 .…”

Prärestaurative Aligner-Therapie eines Deckbisses mit ausgeprägten Zahnhartsubstanzverlusten – ein Fallbericht

“…Neben den allgemein bekannten Vorteilen der FolienTherapie im Bereich der Ästhetik, des Dekalzifizierungsrisi kos und der parodontalen Situation [13][14][15] schützen die Aligner während der kieferorthopädischen Therapie zusätzlich vor weiterem Zahnhartsubstanzverlust. Das Risiko für eine externe Wurzelresorption wird dabei in der Literatur im Vergleich zur Multibrackettherapie als geringer eingeschätzt [16,17].…”

Frequency of awake bruxism behaviour in orthodontic patients: Randomised clinical trial: Awake bruxism behaviour in orthodontic patients

“…The clinical efficiency of these appliances associated with comfort in relation to traditional fixed appliances (FA) has been identified as contributing factors for their large-scale use. 9,10 Studies have investigated the clinical efficacy of aligners and their effects on root resorption, 11 periodontal health, 12 perception of pain and discomfort. 10 It has been reported that orthodontic aligners could be an alternative option for orthodontic treatment in patients with temporomandibular disorder (TMD) 13 and sleep bruxism.…”

“…Studies have investigated the clinical efficacy of aligners and their effects on root resorption, 11 periodontal health, 12 perception of pain and discomfort 10 . It has been reported that orthodontic aligners could be an alternative option for orthodontic treatment in patients with temporomandibular disorder (TMD) 13 and sleep bruxism 9 .…”