Published: 2021-12-27

Prevalence and prevention of orthodontically induced dental resorption

Rehab Fuad Bawyan, Ahmed Nayef Alsharif, Wissam Hussain Alabdalaal, Abdulelah Saad Thakfan, Sarah Taha Alesayi, Ghadah Abdullah Shafei, Manal Mohammed Almarwani, Basmah Mustafa Ageel, Fatma Abdulqader Azouz, Asim Abdulaziz Alkhalifah, Lamis Marwan Farghal, Ahmad Eissa Rawas


Since 1914, when Ottolengui first described it, dentists and patients have been tormented with root resorption, an unwanted but typical sequence of orthodontic mechanotherapeutics. It has been demonstrated that among other potentially hazardous chemicals, the orthodontic equipment employed has a considerable impact on root repair. The‏‏‎ root‏‏‎ repair‏‏‎ process‏‏‎ is‏‏‎ highly‏‏‎ linked‏‏‎ to‏‏‎ periodontal‏‏‎ ligament‏‏‎ necrosis‏‏‎ damage.‏‏‎ When‏‏‎ intense‏‏‎ orthodontic‏‏‎ pressures‏‏‎ are‏‏‎ applied‏‏‎ for‏‏‎ an‏‏‎ extended‏‏‎ length‏‏‎ of‏‏‎ time‏‏‎,‏‏‎ hyalinization‏‏‎ of‏‏‎ the‏‏‎ underlying‏‏‎ periodontal‏‏‎ ligament‏‏‎ can‏‏‎ occur‏‏‎ quickly.‏‏‎ Protective‏‏‎ leukocytes‏‏‎ from‏‏‎ periodontal‏‏‎ ligament‏‏‎ capillaries‏‏‎ mix‏‏‎ quickly‏‏‎ with‏‏‎ osteoclast‏‏‎ progenitors‏‏‎ to‏‏‎ create‏‏‎ cells‏‏‎ with‏‏‎ high-density‏‏‎ genes‏‏‎ capable‏‏‎ of‏‏‎ regenerating‏‏‎ mineral‏‏‎ tissue‏‏‎.‏‏‎ External‏‏‎ apical‏‏‎ root‏‏‎ repair‏‏‎ begins‏‏‎ when‏‏‎ a‏‏‎ protective‏‏‎ layer‏‏‎ of‏‏‎ cementoblasts‏‏‎ including‏‏‎ the‏‏‎ hyalinized‏‏‎ periodontal‏‏‎ ligament,‏‏‎ dies,‏‏‎ allowing‏‏‎ odontoclasts‏‏‎ to‏‏‎ rebuild‏‏‎ cement‏‏‎ and‏‏‎ teeth.‏‏‎ Initially,‏‏‎ a‏‏‎ cemented‏‏‎ protective‏‏‎ layer‏‏‎ is‏‏‎ lost,‏‏‎ exposing‏‏‎ a‏‏‎ green‏‏‎ cement‏‏‎ surface‏‏‎ to‏‏‎ odontoclastic‏‏‎ assaults‏‏‎.‏‏‎ On the other hand, the maxillary second premolar exhibited more excellent root rates in Asians than in Caucasians. The data were taken as evidence that specific races such as Asians were less likely than longer roots to be involved in root repair or were impacted by mutant morphology. In addition, radiographic examination of intermediate IOPAR therapy can detect at-risk teeth and suggest the necessity for appropriate rest to improve performance or anatomical structure. Treatment of afflicted individuals should be continued with caution and proper use of high-intensity light while avoiding movements linked with re-screening such as ingesting.


Dental resorption, Orthodontics, Dental care, Dental health

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Ottolengui R. The physiological and pathological resorption of tooth roots. Dent Item Interest. 1914;36:332.

Ketcham AH. A preliminary report of an investigation of apical root resorption of permanent teeth. Int J Orthodontia Oral Surg Radiograph. 1927;13(2):97-127.

Ketcham AH. A radiographic study of orthodontic tooth movement: a preliminary report. J Am Dent Assoc. 1927;14(9):1577-98.

Krishnan V. Critical issues concerning root resorption: a contemporary review. World J Orthod. 2005;6(1):30-40.

Abass SK, Hartsfield JK. Orthodontics and external apical root resorption. Seminar Orthodont. 2007.

Brudvik P, Rygh P. The initial phase of orthodontic root resorption incident to local compression of the periodontal ligament. Eur J Orthod. 1993;15(4):249-63.

Brudvik P, Rygh P. Root resorption beneath the main hyalinized zone. Eur J Orthod. 1994;16(4):249-63.

Brudvik P, Rygh P. Multi-nucleated cells remove the main hyalinized tissue and start resorption of adjacent root surfaces. Eur J Orthod. 1994;16(4):265-73.

Blaushild N, Michaeli Y, Steigman S. Histomorphometric study of the periodontal vasculature of the rat incisor. J Dent Res. 1992;71(12):1908-12.

Chutimanutskul W, Darendeliler MA, Shen G, Petocz P, Swain MV. Changes in the physical properties of human premolar cementum after application of 4 weeks of controlled orthodontic forces. Eur J Orthod. 2006;28(4):313-8.

Brezniak N, Wasserstein A. Orthodontically induced inflammatory root resorption. part II: the clinical aspects. Angle Orthod. 2002;72(2):180-4.

Malmgren O, Goldson L, Hill C, Orwin A, Petrini L, Lundberg M. Root resorption after orthodontic treatment of traumatized teeth. Am J Orthod. 1982;82(6):487-91.

Sameshima GT, Sinclair PM. Predicting and preventing root resorption: Part I. Diagnostic factors. Am J Orthod Dentofacial Orthop. 2001;119(5):505-10.

Ren Y, Maltha JC, Liem RS, Stokroos I, Kuijpers-Jagtman AM. Age-dependent external root resorption during tooth movement in rats. Acta Odontol Scand. 2008;66(2):93-8.

Picanço GV, Freitas KMSD, Cançado RH, Valarelli FP, Picanço PRB, Feijão CP. Predisposing factors to severe external root resorption associated to orthodontic treatment. Dent Press J Orthodont. 2013;18(1):110-20.

CintraMartins-Ortiz JL, Braga SO. Analysis of predictors of root resorption in orthodontic treatment. J Dentist Oral Hygiene. 2011;3(3):46-52.

Edgcomb K. Prevalence of short dental roots in four ethnic groups in an orthodontic population. University of Illinois Chicago; 2011.

Sameshima GT, Sinclair PM. Predicting and preventing root resorption: part II. Treatment factors. Am J Orthod Dentofacial Orthop. 2001;119(5):511-5.

Davidovitch Z, Krishnan V. Adverse effects of orthodontics: a report of 2 cases. World J Orthodont. 2008;9(3).

Robinson DS, Hamid Q, Ying S, Tsicopoulos A, Barkans J, Bentley AM, et al. Predominant TH2-like bronchoalveolar T-lymphocyte population in atopic asthma. N Engl J Med. 1992;326(5):298-304.

Burstone CJ. The biophysics of bone remodeling during orthodontics (optimal force considerations). Biol Tooth Movement. 1989:321-33.

Abuabara A. Biomechanical aspects of external root resorption in orthodontic therapy. Medicina Oral Patología Oral Cirugía Bucal. 2007;12(8):610-3.

Al-Qawasmi RA, Hartsfield JK, Everett ET, Flury L, Liu L, Foroud TM, et al. Genetic predisposition to external apical root resorption. Am J Orthod Dentofacial Orthop. 2003;123(3):242-52.

Al-Qawasmi RA, Hartsfield JK, Hartsfield JK, Everett ET, Weaver MR, Foroud TM, et al. Root resorption associated with orthodontic force in IL-1Beta knockout mouse. J Musculoskelet Neuronal Interact. 2004;4(4):383-5.

Janson GR, Canto GDL, Martins DR, Henriques JF, DeFreitas MR. A radiographic comparison of apical root resorption after orthodontic treatment with 3 different fixed appliance techniques. Am J Orthod Dentofacial Orthop. 2000;118(3):262-73.

L'Abee EM, Sanderink GC. Apical root resorption during Begg treatment. J Clin Orthod. 1985;19(1):60-1.

Remington DN, Joondeph DR, Artun J, Riedel RA, Chapko MK. Long-term evaluation of root resorption occurring during orthodontic treatment. Am J Orthod Dentofacial Orthop. 1989;96(1):43-6.

Alexander SA. Levels of root resorption associated with continuous arch and sectional arch mechanics. Am J Orthod Dentofacial Orthop. 1996;110(3):321-4.

Beck BW, Harris EF. Apical root resorption in orthodontically treated subjects: analysis of edgewise and light wire mechanics. Am J Orthod Dentofacial Orthop. 1994;105(4):350-61.

Mirabella AD, Artun J. Risk factors for apical root resorption of maxillary anterior teeth in adult orthodontic patients. Am J Orthod Dentofacial Orthop. 1995;108(1):48-55.

Newman WG. Possible etiologic factors in external root resorption. Am J Orthodont. 1975;67(5):522-39.

Brin I, Becker A, Zilberman Y. Resorbed lateral incisors adjacent to impacted canines have normal crown size. Am J Orthod Dentofacial Orthop. 1993;104(1):60-6.

Spurrier SW, Hall SH, Joondeph DR, Shapiro PA, Riedel RA. A comparison of apical root resorption during orthodontic treatment in endodontically treated and vital teeth. Am J Orthod Dentofacial Orthop. 1990;97(2):130-4.

Linge BO, Linge L. Apical root resorption in upper anterior teeth. Eur J Orthod. 1983;5(3):173-83.

McNab S, Battistutta D, Taverne A, Symons AL. External apical root resorption following orthodontic treatment. Angle Orthodont. 2000;70(3):227-32.

Baumrind S, Korn EL, Boyd RL. Apical root resorption in orthodontically treated adults. Am J Orthod Dentofacial Orthop. 1996;110(3):311-20.

Parker RJ, Harris EF. Directions of orthodontic tooth movements associated with external apical root resorption of the maxillary central incisor. Am J Orthod Dentofacial Orthop. 1998;114(6):677-83.

Acar A, Canyürek U, Kocaaga M, Erverdi N. Continuous vs. discontinuous force application and root resorption. Angle Orthod. 1999;69(2):159-63.

Durack C, Patel S, Davies J, Wilson R, Mannocci F. Diagnostic accuracy of small volume cone beam computed tomography and intraoral periapical radiography for the detection of simulated external inflammatory root resorption. Int Endod J. 2011;44(2):136-47.

Sherrard JF, Rossouw PE, Benson BW, Carrillo R, Buschang PH. Accuracy and reliability of tooth and root lengths measured on cone-beam computed tomographs. Am J Orthod Dentofacial Orthop. 2010;137(4):100-8.

Mah J, Prasad N. Dentine phosphoproteins in gingival crevicular fluid during root resorption. Eur J Orthod. 2004;26(1):25-30.

Owman-Moll P, Kurol J. The early reparative process of orthodontically induced root resorption in adolescents--location and type of tissue. Eur J Orthod. 1998;20(6):727-32.

Cheng LL, Türk T, Elekdağ-Türk S, Jones AS, Yu Y, Darendeliler MA. Repair of root resorption 4 and 8 weeks after application of continuous light and heavy forces on premolars for 4 weeks: a histology study. Am J Orthod Dentofacial Orthop. 2010;138(6):727-34.

Owman-Moll P, Kurol J, Lundgren D. Repair of orthodontically induced root resorption in adolescents. Angle Orthod. 1995;65(6):403-8.

Vardimon AD, Graber TM, Pitaru S. Repair process of external root resorption subsequent to palatal expansion treatment. Am J Orthod Dentofacial Orthop. 1993;103(2):120-30.

Baranwal AK. Management of external invasive cervical resorption of tooth with Biodentine: a case report. J Conserv Dent. 2016;19(3):296-9.