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Prevention of external apical root resorption during orthodontic treatment

  • Roberto JustusEmail author
Techniques
  • 121 Downloads
Part of the following topical collections:
  1. Orthodontics

Abstract

The issue of orthodontic-induced external apical root resorption (EARR) has attracted the interest of clinicians and investigators because of the alarming clinical and legal implications associated with its occurrence in a severe form. The January/February 2005 issue of the American Association of Orthodontist’s Bulletin reported that medical malpractice is a significant problem in the USA today and that patients are filing claims and lawsuits against medical and dental practitioners, including orthodontists, in record numbers. EARR is a common iatrogenic consequence of orthodontic treatment. Cross-sectional as well as longitudinal studies show that EARR is a small problem for the average orthodontic patient, with radiographic mean resorption of less than 2.5 mm. This magnitude of resorption has no adverse clinical consequences. However, 1–5% of orthodontic patients experience a severe form of EARR, defined as exceeding 4 mm or one-third of the original root length. Severe root resorption mainly occurs in maxillary incisors. It compromises crown–root ratios and can result in tooth mobility. The main etiologic risk factor for the severe form of EARR is genetic predisposition. Emphasis is thus given on the root-sparing treatment procedures to minimize the risk for development of the severe form of EARR. Orthodontists are highly trained dental caregivers obligated to abide by the Hippocratic Oath of doing no harm. It is the author’s hope that this article will create awareness among clinicians that there are orthodontic and orthopedic treatment regimes designed precisely to minimize or even avoid the development of EARR. Successful treatment should begin at a young age so that the clinician can take advantage of eruption guidance and of growth modification when a Class II skeletal problem exists. Suggested treatment regimes outlined in this paper minimize the distance that teeth/root apices need to be moved.

Keywords

External apical root resorption Orthodontic treatment Genetic predisposition Risk management Root-sparing treatment procedures Eruption guidance Growth modification 

Further reading

  1. 1.
    Justus R (2015) Iatrogenic effects of orthodontic treatment: decision-making in prevention, diagnosis, and treatment. Prev Extern Apical Root Resorption.  https://doi.org/10.1007/978-3-319-18353-4_3 CrossRefGoogle Scholar
  2. 2.
    Proffit WR, Fields HW, Sarver DM (2007) Contemporary Orthodontics, 4th edn. Mosby Inc., Saint Louis, pp 279–283Google Scholar
  3. 3.
    Weltman BJ (2011) External root resorption and orthodontic treatment—assessment of the evidence. In: Huang GJ, Richmond S, Vig KWL (eds) Evidence-based orthodontics. Wiley, Chichester, pp 63–87Google Scholar
  4. 4.
    Weltman B, Vig KWL, Fields HW et al (2010) Root resorption associated with orthodontic tooth movement: a systematic review. Am J Orthod Dentofacial Orthop 137:462–476CrossRefPubMedGoogle Scholar
  5. 5.
    Chan E, Darendeliler MA (2006) Physical properties of root cementum: part 7. Extent of root resorption under areas of compression and tension. Am J Orthod Dentofacial Orthop 129:504–510CrossRefPubMedGoogle Scholar
  6. 6.
    Levander E, Malmgren O, Eliasson S (1994) Evaluation of root resorption in relation to two orthodontic treatment regimes. A clinical experimental study. Eur J Orthod 16:223–228CrossRefPubMedGoogle Scholar
  7. 7.
    Årtun J, Smale I, Behbehani F et al (2005) Apical root resorption six and 12 months after initiation of fixed orthodontic appliance therapy. Angle Orthod 75:919–926PubMedGoogle Scholar
  8. 8.
    Al-Qawasmi RA, Hartsfield JK Jr, Everett ET et al (2003) Genetic predisposition to external apical root resorption. Am J Orthod Dentofacial Orthop 123:242–252CrossRefPubMedGoogle Scholar
  9. 9.
    Brin I, Tulloch JFC, Koroluk L et al (2003) External apical root resorption in Class II malocclusion: a retrospective review of 1-versus 2-phase treatment. Am J Orthod Dentofacial Orthop 124:151–156CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Universidad Intercontinental, Facultad de OdontologiaMexico CityMexico

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