Root Resorption with Orthodontic Mechanics: Pertinent Areas Revisited

Abstract

Root resorption can occur at any time during orthodontic treatment and lead to a compromise in the prognosis of the tooth and the stability of the treatment results. Recent research has focused more on the cause and effect relationship as well as preventive or treatment options to combat this unwelcome event. Investigations have highlighted the genetic as well as molecular aspects of the process and enabled clinicians to determine which patients might be susceptible. A proper medical history, an assessment of predisposing factors, a radiographic evaluation for alterations in root morphology and careful planning and execution of orthodontic mechanics may reduce the incidence of root resorption. The current review is aimed at providing clinicians and academics with an insight into the process of root resorption, the methods of identification during its early stages and intervention at the right time to reduce its severity.

Sequential traction of a labio-palatal horizontally impacted maxillary canine with a custom three-directional force device in the space of a missing ipsilateral first premolar

“…A panoramic radiograph exhibited favorable root alignment; the root of the maxillary left canine was surrounded by substantially regenerated alveolar bone, while the roots of the maxillary right lateral and center incisors had some resorption, which may be due to the extended duration of orthodontic treatment, intrusion and bodily movement of the teeth, and genetic factors ( Figures 19 , 20 , 21 ). 10 11 12 13 14 The maxillary left third molar was extracted for correction of the scissor bite of the maxillary and mandibular left second molar. The patient refused maxillary right third molar and mandibular third molar extractions despite our recommendation.…”

Orthodontic treatment of an adult patient with aggressive periodontitis – A case report

“…In these case, the center of resistance was moved apically, and large moments are needed to control the root movement given the increased moment of the applied force (Nanda, 2012). (Figure 7) (Alexander, 1996;Krishnan, 2017). In addition, other advantage of using upper removable appliance covering the palate in this case could reduce the mesial migration of molars, termed the "row-boat effect" (Kim et al, 2014).…”

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

“…Existe una mayor prevalencia de reabsorción radicular y pacientes alérgicos y/o asmáticos 1,14,25 ya que se producen ciertos mediadores inflamatorios como la Interleuquina 4, 5, 6, 10 y 13) responsables de RRE 8,25 . La administración de suplementos tiroideos beneficia a los pacientes en la fase inicial de la reabsorción radicular, al detener en muchas ocasiones el proceso.…”

“…La mayoría de los estudios coinciden que los incisivos laterales superiores son los dientes más propensos a sufrir de RRE debido a la extensión del movimiento durante el tratamiento y presentan mayor probabilidad de tener raíces con dilaceración hacia distal 26 . Respecto a la morfología radicular, raíces cortas, dilaceradas, puntiagudas o con forma de pipeta son más propensas a reabsorberse porque distribuyen de manera diferente las fuerzas 1,3,15,25 , al aplicar una fuerza a nivel del ápice, la distribución de la carga es diferente a la que se genera en una raíz con una anatomía radicular normal, , causando un trauma al ligamento periodontal 3 .…”

“…De acuerdo a la maloclusión, Fang y colaboradores en su estudio comprobaron que sí es un factor de riesgo para la reabsorción radicular 25 , ya que está relacionada por la mayor cantidad de movimiento dental necesario en el tratamiento ortodóncico 3,20 . En cuanto al tipo de maloclusión, algunos autores indican que un exceso vertical y las mordidas abiertas tienden a presentar mayores índices de RRE 1 , otros indican que las mordidas abiertas y un overjet aumentado son más propensos 9 , Maués y colaboradores obtuvieron como resultado que un overjet superior a 5 mm es un factor de riesgo para RRE severa.…”