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PubMed2006

[The reliability of digital periapical films in diagnosis of root resorption].

OBJECTIVE: To investigate the difference between digital periapical film and conventional film in the evaluation of tooth length and root resorption. METHODS: A standard for root resorption in vitro was developed based on 20 extracted upper central incisors. Digital periapical films and conventional periapical films were taken before and after the process of simulating root resorption at six different projection angles respectively. The tooth length and root resorption were measured on these films. The results were analyzed by paired-samples rank sum test. RESULTS: Significant difference on tooth length measurement was found between two types of films on the same projection angle. No significant difference on the length of root resorption calculated on digital and conventional films was found. CONCLUSIONS: The accuracy of the digital periapical film was greater than that of conventional periapical films. The conventional periapical film can still be used in the evaluation of root resorption.

Humans↗
PubMed1994

Root resorption beneath the main hyalinized zone.

A previous investigation on the initial phase of root resorption associated with orthodontic overcompression of local areas of the periodontal ligament (PDL), indicated that a differentiation should be made between two stages: (1) the very first resorption occurring in the periphery of the main necrotic zone; and (2) the root resorption occurring on that part of the root surface situated beneath the main bulk of necrotic tissue (Brudvik and Rygh, 1993a). The aim of the present investigation was to study the latter stage. Attention was focused on: (1) the possible association between the presence of necrotic tissue and root resorption; and (2) the cells that invaded and removed the necrotic tissue, as well as the cells that started to remove/resorb the cementum. Mesial movement of the upper first molars (rats) and lower first molars (mice) was performed by a fixed orthodontic appliance. The results indicate an association between the root resorption, and the presence and active removal of the hyalinized tissue. Root resorption beneath the main hyalinized zone occurred in areas where invading cells were observed close to the root surface. The majority of the cells involved in removal of the necrotic tissue and resorption of the root surface were multi-nucleated and TRAP-positive. It is hypothesized that multi-nucleated TRAP-positive cells when reaching the subjacent contaminated and damaged root surface after having removed necrotic PM tissue, continued to remove the cementum surface.

Acid Phosphatase↗
PubMed1992

A case of progressive external root resorption treated with surgical exposure and composite restoration.

Progressive external, root resorption was observed apical to the alveolar crest on the buccal surface of a tooth. The area of root resorption was surgically exposed. To gain access to the root resorption cavity osteoectomy was performed. The soft tissue in the resorption cavity was removed and a composite filling (Retroplast) was placed in the cavity using a dentine bonding system (Gluma). The pulp was removed and the root canal was obturated with gutta-percha points and root canal sealer (AH26). Eight months after treatment no further root resorption was observed. Increased pocket depth and slight bleeding on probing in the area of resorption were evident.

Bicuspid↗
PubMed2003

Dental root resorption and repair: histology and histometry during physiological drift of rat molars.

OBJECTIVE: The process of dental root resorption and subsequent cementum regeneration has not been sufficiently elucidated. This study aimed to examine the process of the root resorption and cementum regeneration during physiological tooth drift using a rat model, and to evaluate this experimental model. METHODS: Distal roots in mandibular first molars and the surrounding periodontal tissues were investigated with light and electron microscopy. The light microscopic approach included histochemical and histometric analyses utilizing the tartrate-resistant acid phosphatase (TRAP) reaction. RESULTS: Root resorption was observed in the distal side of the roots and was most active in 5- to 6-week-old rats, and gradually decreased hereafter. An increase in the number of TRAP-positive mononuclear cells, which seemed to be odontoclast precursor cells, preceded the increase in the number of odontoclasts. Root resorption was transient, and was followed by the new formation of acellular extrinsic fiber cementum accompanied with only a slight inflammation, and therefore classified as external surface resorption. Preparation for new cementum started adjacent to the resorption areas when root resorption was most active. CONCLUSIONS: The root resorption during drift in rats is transient and followed by acellular extrinsic fiber cementum regeneration. Cellular kinetics suggested that odontoclast precursor cells are supplied as mononuclear cells from vascular spaces.

Acid Phosphatase↗
PubMed1986

Root resorption in maxillary central incisors following active orthodontic treatment.

The purpose of this study was to determine if apical root resorption associated with orthodontic treatment continues after the termination of active treatment (that is, the removal of fixed appliances). A sample of 45 subjects who had experienced root resorption during treatment was selected from the orthodontic clinic at the State University of New York at Buffalo. The length of the maxillary central incisors was measured from lateral cephalometric radiograms taken before treatment, after active treatment, and after retention. From these data, the resorption occurring during and after active treatment was calculated. The mean amount of root resorption during active treatment was 2.93 mm. The mean amount of root resorption during the posttreatment period was 0.1 mm. There was a statistical difference between these two means using the Student's t test at the 0.05 level of significance. The reliability coefficient comparing the first tracings and measurements in the 19 cases that were retraced and remeasured was r = 0.993. The data from this radiographic study support the hypothesis that root resorption associated with orthodontic treatment ceases with the termination of active treatment. There was also evidence to suggest that when posttreatment root resorption does occur, it is not necessarily associated with large amounts of root resorption during the active treatment period. It is more likely associated with other factors, such as traumatic occlusion and active force-delivering retainers.

Adolescent↗
PubMed2003

The effect of prostaglandin E2 and calcium gluconate on orthodontic tooth movement and root resorption in rats.

Possible modifications in orthodontic tooth movement (OTM) and root resorption as a result of local injections of prostaglandin E2 (PGE2) alone and with calcium gluconate (Ca) formed the aim of the present study. Twenty-four 8-week-old male Wistar rats were selected and randomly divided into three groups of eight. Both quadrants of the upper jaws of the first group of animals were used; therefore this group comprised two groups: control and normal. The upper left first molars of these eight animals were not placed under orthodontic force and received no injection, to serve as the normal group, considered for root resorption comparison only. The control group had localized submucosal injections of normal saline on the buccal side of the upper right first molar. In the third group, 0.1 ml of 1 mg/ml PGE2 was injected at the same site and the fourth group received an intraperitoneal injection of 200 mg/kg Ca (10%) in addition to the PGE2. All the injections were performed on days 0 and 7. The orthodontic appliance consisted of a closed coil spring ligated to the upper right first molar and incisor, exerting a force of 60 g during the 21-day experimental period, after which the animals were sacrificed. Palatal halves were removed for histological examination and for calculation of the amount of root resorption. Statistical analysis of data showed a significant (P < 0.05) acceleration in OTM after PGE2 injection compared with the control group. The addition of Ca reduced OTM but a significant increase (P< 0.05) was still recorded. A significant difference (P < 0.05) in root resorption was only observed between the PGE2 and normal groups. The findings show the importance of calcium ions working in association with PGE2 in stabilizing root resorption while significantly increasing OTM.

Analysis of Variance↗
PubMed2004

The genetic contribution to orthodontic root resorption: a retrospective twin study.

BACKGROUND: One of the difficulties in assessing the causes of root resorption is to separate the contribution made by genetic factors from those due to environmental factors, such as treatment. OBJECTIVE: The aim of this study was to investigate the genetic contribution to orthodontic root resorption. METHODS: The subjects of this investigation were 16 monozygotic (MZ) and 10 dizygotic (DZ) twins. All twins had zygosity diagnosed using microsatellite analysis. Each twin-pair had same type of malocclusion, were treated with the same type of appliance, and by the same clinician. The lengths of the maxillary incisors, mandibular incisors, and mandibular molars were assessed both qualitatively and quantitatively, on pre- and post-treatment panoramic films. The genetic contribution to external apical root resorption was assessed using concordance and heritability estimates. RESULTS: Concordance estimates from the qualitatively and quantitatively measured external apical root resorption were 44.9 per cent and 49.2 per cent respectively for the MZ twins, and 24.7 per cent and 28.3 per cent respectively for DZ twins. An overall heritability estimate of 0.34 was obtained. CONCLUSIONS: External apical root resorption was not dependent on the pretreatment root length. Qualitatively and quantitatively determined estimates of concordance indicate a genetic component to root resorption. A larger sample is needed before models of heritability can be used to determine the components contributing to the variance.

Adolescent↗
PubMed1987

The effect of an antibiotic/corticosteroid paste on inflammatory root resorption in vivo.

Progressive external inflammatory root resorption, a result of persistent inflammation within the periodontal membrane, will cause eventual destruction of the tooth root if the inflammation is not eradicated. This study examined the effects of an antibiotic/corticosteroid paste on experimental inflammatory resorption induced in monkeys in vivo. Histologic evaluation of results with the use of a morphometric technique revealed that the paste eliminated inflammatory root resorption and had no damaging effects upon the periodontal membrane. It was concluded that this antibiotic/corticosteroid combination is an effective medication for use in the treatment of progressive root resorption in traumatically injured teeth.

Animals↗
PubMed1996

Prevalence and severity of apical root resorption and alveolar bone loss in orthodontically treated adults.

This study assessed the frequency of root resorption and alveolar bone loss in 88 adults who had undergone orthodontic treatment. Pretreatment and posttreatment periapical radiographs were used to determine the amount of external apical root resorption and alveolar bone loss of the maxillary and mandibular incisors. Alveolar bone loss in the posterior quadrants was determined from bite-wing radiographs. The number of incisors showing root resorption, including blunting, increased from 15% before treatment to 73% after treatment. The number of incisors having moderate to severe apical root resorption was 2% before treatment and 24.5% after treatment. The number of anterior sites in which loss of alveolar bone height exceeded 2 mm from the cementoenamel junction to the alveolar crest increased from 19% before treatment to 37% after treatment; the number of posterior sites was 7% before treatment and 14% after treatment. Bone LOSS > or = 1.5 mm from the pretreatment to posttreatment stages occurred in 11% of the incisors and 3% of the posterior sites. A marked increase in the prevalence of root resorption and alveolar bone loss occurred over the course of treatment. The prevalence of iatrogenic effects for adults may be higher for incisors than in previously reported adolescent studies. A small subgroup with multiple sites of either root resorption or bone loss account for a disproportionate number of iatrogenic sequelae. However, in general, the iatrogenic experience did not preclude the orthodontic treatment of adults.

Adult↗
PubMed2005

Root resorption in deciduous teeth after applying orthodontic forces.

The relation between orthodontic forces applied to deciduous teeth and the occurrence of root resorption, as a possible outcome of these forces, has not been studied to date. The aim of this work was to study root resorption in deciduous teeth of patients receiving orthodontic treatment. Twenty-four deciduous molars extracted for therapeutic purposes were studied: nineteen molars treated with light orthodontic forces and five untreated molars that served as control. Histological and histomorphome tric studies were performed to determine the magnitude of root resorption. Location of root resorption in treated deciduous teeth was different from that of physiological root resorption. Extent and volume of root resorption were more extensive and deeper in treated than in untreated teeth. These results suggest that radiographic follow-up of deciduous teeth subjected to orthodontic forces would be useful to prevent root fractures.

Case-Control Studies↗
PubMed2006

Root resorption after orthodontic treatment.

BACKGROUND: Orthodontic treatment can result in root resorption. OBJECTIVE: To determine if apical root resorption is related to the type of appliance used and/or the direction and amount of tooth movement. METHODS: The pre- and post-treatment tooth lengths of the maxillary and mandibular first molars and incisors were measured on panoramic radiographs of 114 subjects. Associations between changes in the lengths of the incisors and positional changes in the upper and lower central incisors were determined for 45 subjects with pre- and post-treatment cephalometric radiographs. RESULTS: Taking into account the gender and OPT machine seven statistically significant differences were found between the appliance groups for the lengths of teeth 31 and 41. Within the groups four teeth decreased significantly in length when the pre-adjusted appliance was used (teeth 12, 11, 21, 26) and four teeth when the Speed appliance was used (teeth 26, 31, 41, 42). Only tooth 31 was shorter when the Tip-Edge appliance was used. Lower incisors were significantly shorter post-treatment if the apices were moved close to the lingual cortex. CONCLUSIONS: When panoramic radiographs are used to assess treatment-induced changes in the lengths of the incisors, apical resorption is only one factor that should be considered. The images of lower incisors proclined during treatment may be foreshortened and/or the apices may lie outside the focal plane: both may result in 'shorter' teeth post-treatment. Because of the confounding factors panoramic radiographs may not be a reliable method of determining apical root resorption.

Adolescent↗
PubMed1994

Premature or delayed exfoliation of deciduous teeth and root resorption and formation.

The present cross-sectional study was based on orthopantomograms of 1245 Greek children (590 males and 655 females), whose ages ranged from 6 years 10 months to 14 years. Three orthodontic practices were the source of these orthopantomograms which were taken before the start of orthodontic treatment. The resorption process of the deciduous mandibular canine and molar roots was divided into five stages and the root formation process of their permanent successors into eight stages. The percentage distribution of the deciduous root resorption stages for each root formation stage of the corresponding permanent teeth was then recorded. Exfoliation of these three deciduous teeth occurred when the root formation of their successors had reached the R2/3, R3/4 or the beginning of the Rc stage. As far as the effect of local factors on root resorption and formation process our findings indicated that decay, pulp necrosis and pulpotomy hastened the rate of root resorption of the deciduous molars, while they did not influence the rate of root formation of the corresponding permanent teeth.

Adolescent↗
PubMed1995

Root resorption related to orthodontics and other factors: a review of the literature.

Each patient (and parents or guardian) should be clearly informed that there is a real possibility of one or more teeth undergoing root resorption during orthodontic procedures. They should sign an Information and Consent Form arranged by the dentist that they understand these risks before treatment is begun. Open bite cases possess significantly great degrees of resorption. Since trauma is closely associated with root resorption, the patient (and parents or guardian) should be questioned concerning previous traumatic occurrences that involved blows or accidents involving the teeth. Periapical radiographs are an important part of orthodontic records. They are useful to compare pretreatment and posttreatment root resorption. Maxillary incisors are affected more frequently and to a greater degree than the rest of the teeth during active treatment. Also, root resorption of the upper incisors during the initial 6-9 months of treatment with fixed appliances gives a high risk for continued resorption during the subsequent treatment. Therefore, it would be prudent to take periapical radiographs periodically during treatment. When root resorption is detected during active treatment, a decision must be made as to whether to continue, modify or discontinue the treatment. Extremely heavy forces should be avoided, since they have been shown to produce greater resorption activity. The ectopic eruption of canines causes a significant number of resorptions in lateral incisors. Habits adversely affect root resorption and should be eliminated if possible. Pathological lesions increase the risk of resorption. Periodontal disease increases the risk of resorption. The practitioner contemplating doing orthodontics should be cognizant of the above factors in evaluating the risk of root resorption. Patients (and parents or guardians) should be made clearly aware that any type of orthodontic treatment carries with it the risk of root tip blunting or resorption during orthodontic therapy.

Child↗
PubMed2003

Apical root resorption after lingual orthodontic therapy.

PURPOSE: Apical root resorptions are among the undesirable side effects of orthodontic therapy. The aim of the present study was to investigate radiologically whether and to what extent resorptions occur in patients treated solely with a fixed lingual appliance, as well as the pathogenetic relevance of the extent and direction of the therapeutically induced apical movement. PATIENTS AND METHODS: The collective comprised 33 female and seven male patients with a mean age of 24.2 +/- 8.4 years. Permanent lower premolars were extracted in five, and permanent upper premolars in 22 patients. In total, 456 upper and lower incisors and canines were assessed. In order to evaluate the relative change in root length and the sagittal and vertical apical movements, pre- and posttherapeutic panoramic radiographs and/or lateral cephalograms were analyzed. RESULTS: After completion of orthodontic treatment the mean root length was 96.3%, corresponding to a resorption rate of 3.7%. The resorption rates of teeth 11, 12 and 21 differed significantly from those of teeth 31, 32 and 43. Upper incisors presented increased mean resorption rates < or = 10%. Only 18% of the 456 teeth analyzed were affected by pronounced resorptions > 10%. 82% of the teeth were resorption-free. A patient-related evaluation revealed that 26 of the 40 patients had no resorptions > 20%, while 14 had between one and four affected teeth. No significant relationship between extent of resorption and parameters such as age, gender, active treatment time, Angle class, or extent and direction of apical movement was recorded. CONCLUSIONS: The results suggest that lingual orthodontic therapy resulted in only slight root resorptions. Pronounced root shortenings were observed in some patients whose individual predisposition may constitute the main risk factor for the occurrence of root resorptions.

Adolescent↗
PubMed2005

Celebrex offers a small protection from root resorption associated with orthodontic movement.

UNLABELLED: Tooth movement results from alveolar bone resorption/deposition following application of orthodontic forces, and root resorption can be an undesirable complication associated with this process. No treatment for external root resorption is available to date. OBJECTIVE: To determine if COX-2 inhibitors like Celebrex are effective in protecting root resorption associated with orthodontic forces. METHODS: A force of 80 grams was applied to the left maxillary first molars of 7-week-old female Wistar rats using nickel titanium closed coil springs attached to the cervical area of the incisors with 0.010 stainless-steel ligature wires. Twenty animals were divided into three experimental groups: one receiving no treatment, the second receiving 25mg/kg, and the third receiving 50 mg/kg of celecoxib (Celebrex) in their drinking water. Rats were maintained on a soft diet and euthanized two weeks after initial placement of the force. Paraffin-embedded sections of the right (control) and left (experimental) maxillae were stained with H&E and the areas of root resorption were examined by counting the number of lacunaes in the roots. RESULTS: No difference in the distance of tooth movement (0.5 mm/two weeks) was seen in all three groups. The rats that received the low dose of Celebrex showed no statistically significant difference in root resorption than that of the rats that received no dose. The rats that received the high dose of Celebrex showed a lower number of lacunaes (mean = 3.5) than that of the control group (mean 10.2; p=0.02). CONCLUSIONS: Administration of Celebrex during the application of orthodontic forces does not interfere with tooth movement and appears to offer some slight protection against root resorption.

Animals↗
PubMed2004

Bone structure effect on root resorption.

OBJECTIVES: To explore if alveolar bone shape and density might promote external apical root resorption. SETTING AND SAMPLE POPULATION: Panoramic radiographs of 700 patients who had orthodontic treatment at Temple University were reviewed and 22 patients with radiographic evidence of root resorption on the lower incisors were selected for the study. Exclusion criteria included a history of systemic diseases, craniofacial abnormalities, tooth injury, endodontically treated teeth, and impacted teeth. METHODS: Pre-treatment (T1) and post-treatment (T2) cephalometric radiographs were converted into digital format and enhanced to reduce contrast variability and improve edge definition. Tooth length, root length, root area, alveolar area around the root including cortical area, area of medullary bone, and area of the symphysis were measured using an interactive software algorithm. A region of interest within the symphysis was also defined and trabecular space area and fractal dimension calculated as an estimate of bone density. RESULTS: Root area and tooth length were correlated negatively with changes in root area, tooth area, and root length. Larger teeth demonstrated a greater amount of root resorption. Dentoalveolar complex dimensions remained relatively unchanged during tooth movement. The amount of alveolar bone around the root, thickness of cortical bone, density of the trabecular network, and fractal dimension showed no significant correlation with the extent of the external apical root resorption. CONCLUSIONS: The results of this study suggest that the density and morphology of the dentoalveolar complex are not significant factors in the etiology of external apical root resorption.

Adolescent↗