Skip to main content
SpringerLink
Log in

External apical root resorption after nonextraction orthodontic treatment with labial vs. lingual fixed appliances

Externe apikale Wurzelresorption nach labialer vs. lingualer kieferorthopädischer Behandlung mit festsitzenden Apparaturen ohne Extraktion

  • Original Article
  • Published:
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objectives

The aim of this retrospective study is to compare external apical root resorption (EARR) after labial and lingual fixed orthodontic treatment, as detected with panoramic radiographs.

Materials and methods

Sixty subjects were divided into two groups according to the treatment type: lingual (30 patients) and labial (30 patients) fixed orthodontic treatment. Panoramic radiographs which were obtained at the beginning of treatment (T0) and at the end of the treatment (T1) were evaluated. The maxillary and mandibular central and lateral incisors, as well as canine crown and root lengths were measured for T0 and T1. Crown to root ratios were used to determine EARR. Data were evaluated using analysis of variance and χ2 analysis.

Results

In all, 5 patients (16.7%) in the lingual group and 7 patients (23.3%) in the labial group had a minimum of one tooth with severe EARR, while 9 patients (30%) in the lingual group and 14 patients (46.7%) in the labial group had no EARR. A total of 26 teeth (7.2%) in the lingual group and 34 teeth (9.4%) in the labial group developed severe EARR; however, 184 teeth (51.1%) in the lingual group and 202 teeth (56.1%) in the labial group did not reveal any EARR. No statistically significant difference was found for the resorption rates between the treatment groups (p > 0.05). Although not statistically significant, there was a higher percentage of severe EARR in the mandible within the labial group.

Conclusions

Both lingual and labial orthodontic techniques showed statistically similar root resorption rates. EARR is a multifactorial issue and individual predispositions must also be taken into consideration.

Zusammenfassung

Ziele

Ziel dieser retrospektiven Studie ist es, externe apikale Wurzelresorptionen (EARR) nach labialer und lingualer festsitzende kieferorthopädischer Behandlung anhand Untersuchungen an Panoramaschichtaufnahmen zu vergleichen.

Material und Methoden

Sechzig Probanden wurden je nach Behandlungsart in die folgenden 2 Gruppen eingeteilt: linguale (30 Patienten) und labiale (30 Patienten) festsitzende kieferorthopädische Behandlung. Zu Beginn der Behandlung (T0) und am Ende der Behandlung (T1) wurden Panoramaschichtaufnahmen angefertigt und ausgewertet. Kronen- und Wurzellängen der zentralen und lateralen Inzisiven sowie der Eckzähne in Ober- und Unterkiefer wurden zu den Zeitpunkten T0 und T1 gemessen. Mittels der Kronen-Wurzel-Verhältnisse wurde die EARR bestimmt. Die Datenauswertung erfolgte mittels Varianz- und χ2-Analyse.

Ergebnisse

Insgesamt hatten 5 Patienten (16,7%) in der lingualen Gruppe und 7 Patienten (23,3%) in der labialen Gruppe mindestens einen Zahn mit schwerer EARR, während 9 Patienten (30%) in der lingualen Gruppe und 14 Patienten (46,7%) in der labialen Gruppe keine EARR aufwiesen. Insgesamt 26 Zähne (7,2%) in der lingualen und 34 Zähne (9,4%) in der labialen Gruppe entwickelten eine schwere EARR; jedoch zeigten 184 Zähne (51,1%) in der lingualen und 202 Zähne (56,1%) in der labialen Gruppe keine EARR. Ein statistisch signifikanter Unterschied für die Resorptionsraten zwischen den Behandlungsgruppen wurde nicht gefunden (p > 0.05). Obwohl statistisch nicht signifikant, gab es innerhalb der Labialgruppe einen höheren Prozentsatz an schwerer EARR im Unterkiefer.

Schlussfolgerungen

Sowohl linguale als auch labiale kieferorthopädische Techniken zeigten statistisch ähnliche Wurzelresorptionsraten. Die EARR ist ein multifaktorielles Phänomen, bei dem auch individuelle Prädispositionen zu berücksichtigen sind.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1 Abb. 1
Fig. 2 Abb. 2

Similar content being viewed by others

References

  1. Rygh P (1977) Orthodontic root resorption studied by electron microscopy. Angle Orthod 47:1–16

    PubMed  Google Scholar 

  2. Krishnan V (2017) Root resorption with orthodontic mechanics: pertinent areas revisited. Aust Dent J 62:71–77

    PubMed  Google Scholar 

  3. Abuabara A (2007) Biomechanical aspects of external root resorption in orthodontic therapy. Med Oral Patol Oral Cir Bucal 12:610–613

    Google Scholar 

  4. Brezniak N, Wasserstein A (1993) Root resorption after orthodontic treatment: Part 2. Literature review. Am J Orthod Dentofacial Orthop 103:138–146

    PubMed  Google Scholar 

  5. Harris DA, Jones AS, Darendeliler MA (2006) Physical properties of root cementum: Part 8. Volumetric analysis of root resorption craters after application of controlled intrusive light and heavy orthodontic forces: a microcomputed tomography scan study. Am J Orthod Dentofacial Orthop 130:639–647

    PubMed  Google Scholar 

  6. Chan E, Darendeliler MA (2005) Physical properties of root cementum: Part 5. Volumetric analysis of root resorption craters after application of light and heavy orthodontic forces. Am J Orthod Dentofacial Orthop 27:186–195

    Google Scholar 

  7. Casa MA, Faltin RM, Faltin K, Sander FG, Arana-Chavez VE (2001) Root resorptions in upper first premolars after application of continuous torque moment. Intra-individual study. J Orofac Orthop 62:285–295

    PubMed  Google Scholar 

  8. Barbagallo LJ, Jones AS, Petocz P, Darendeliler MA (2008) Physical properties of root cementum: Part 10. Comparison of the effects of invisible removable thermoplastic appliances with light and heavy orthodontic forces on premolar cementum. A microcomputed-tomography study. Am J Orthod Dentofacial Orthop 133:218–227

    PubMed  Google Scholar 

  9. 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 129:504–510

    PubMed  Google Scholar 

  10. Baumrind S, Korn EL, Boyd RL (1996) Apical root resorption in orthodontically treated adults. Am J Orthod Dentofacial Orthop 110:311–320

    PubMed  Google Scholar 

  11. Guo Y, He S, Gu T, Liu Y, Chen S (2016) Genetic and clinical risk factors of root resorption associated with orthodontic treatment. Am J Orthod Dentofacial Orthop 150:283–289

    PubMed  Google Scholar 

  12. Al-Qawasmi RA, Hartsfield JK Jr., Everett ET, Flury L, Liu L, Foroud TM et al (2003) Genetic predisposition to external apical root resorption. Am J Orthod Dentofacial Orthop 123:242–252

    PubMed  Google Scholar 

  13. Massler M, Malone AJ (1954) Root resorption in human permanent teeth: a roentgenographic study. Am J Orthod 40:619–633

    Google Scholar 

  14. Lupi JE, Handelman CS, Sadowsky C (1996) Prevalence and severity of apical root resorption and alveolar bone loss in orthodontically treated adults. Am J Orthod Dentofacial Orthop 109:28–37

    PubMed  Google Scholar 

  15. Levander E, Bajka R, Malmgren O (1998) Early radiographic diagnosis of apical root resorption during orthodontic treatment: a study of maxillary incisors. Eur J Orthod 20:57–63

    PubMed  Google Scholar 

  16. Janson GR, De Luca Canto G, Martins DR, Henriques JF, De Freitas MR (2000) A radiographic comparison of apical root resorption after orthodontic treatment with 3 different fixed appliance techniques. Am J Orthod Dentofacial Orthop 118:262–273

    PubMed  Google Scholar 

  17. McNab S, Battistutta D, Taverne A, Symons AL (1999) External apical root resorption of posterior teeth in asthmatics after orthodontic treatment. Am J Orthod Dentofacial Orthop 116:545–551

    PubMed  Google Scholar 

  18. Brin I, Tulloch JF, Koroluk L, Philips C (2003) External apical root resorption in Class II malocclusion: a retrospective review of 1‑ versus 2‑phase treatment. Am J Orthod Dentofacial Orthop 124:151–156

    PubMed  Google Scholar 

  19. Levander E, Malmgren O, Stenback K (1998) Apical root resorption during orthodontic treatment of patients with multiple aplasia: a study of maxillary incisors. Eur J Orthod 20:427–434

    PubMed  Google Scholar 

  20. Taithongchai R, Sookkorn K, Killiany DM (1996) Facial and dentoalveolar structure and the predictionof apical root shortening. Am J Orthod Dentofacial Orthop 110:296–302

    PubMed  Google Scholar 

  21. Fritz U, Diedrich P, Wiechmann D (2002) Lingual technique—patient’ characteristics, motivation and acceptance. J Orofac Orthop 63:227–233

    PubMed  Google Scholar 

  22. Fritz U, Diedrich P, Wiechmann D (2003) Apical root resorption after lingual orthodontic therapy. J Orofac Orthop 64:434–442

    PubMed  Google Scholar 

  23. Nassif CE, Cotrim-Ferreira A, Conti ACFC, Danilo PV et al (2017) Comparative study of root resorption of maxillary incisors in patients treated with lingual and buccal orthodontics. Angle Orthod 87:795–800

    PubMed  Google Scholar 

  24. Gay G, Ravera S, Castroflorio T, Garino F, Rossini G, Parrini S et al (2017) Root resorption during orthodontic treatment with Invisalign(R): a radiometric study. Prog Orthod 18:12

    PubMed  PubMed Central  Google Scholar 

  25. Fritz U, Diedrich P, Wiechmann D (2002) Lingual technique—patients’ characteristics, motivation and acceptance. Interpretation of a retrospective survey. J Orofac Orthop 63:227–233

    PubMed  Google Scholar 

  26. Echarri P (2006) Revisiting the history of lingual orthodontics: a basis for the future. Semin Orthod 12:153–159

    Google Scholar 

  27. Moran KI (1987) Relative wire stiffness due to lingual versus labial interbracket distance. Am J Orthod 92:24–32

    Google Scholar 

  28. Geron S, Romano R, Brosh T (2004) Vertical forces in labial and lingual orthodontics applied on maxillary incisors—a theoretical approach. Angle Orthod 74:195–201

    PubMed  Google Scholar 

  29. Nanda R, Kuhlberg A (1997p) Principles of biomechanics. In: Nanda R (ed) Biomechanics in clinical orthodontics. WB Saunders Co, Philadephia, pp 1–22

    Google Scholar 

  30. Brezniak N, Wasserstein A (1993) Root resorption after orthodontic treatment: Part 1. Literature review. Am J Orthod Dentofacial Orthop 103:62–66

    PubMed  Google Scholar 

  31. Alexander SA (1996) Levels of root resorption associated with continuous arch and sectional arch mechanics. Am J Orthod Dentofacial Orthop 110:321–324

    PubMed  Google Scholar 

  32. Hartsfield JK Jr., Everett ET, Al-Qawasmi RA (2004) Genetic factors in external apical root Resorption and orthodontic treatment. Crit Rev Oral Biol Med 15:115–122

    PubMed  Google Scholar 

  33. Abass S, Hartsfield JK (2007) Orthodontics and external apical root resorption. Seminars in Orthodontics 13:146–256

    Google Scholar 

  34. Levander E, Malmgren O (1998) Evaluation of the risk of root resorption during orthodontic treatment: a study of upper incisors. Eur J Orthod 10:30–38

    Google Scholar 

  35. Sehr K, Bock NC, Serbesis C, Honemann M, Ruf S (2011) Severe external apical root resorption—local cause or genetic predisposition? J Orofac Orthop 72:321–331

    PubMed  Google Scholar 

  36. Beck BW, Harris EF (1994) Apical root resorption in orthodontically treated subjects: analysis of edgewise and light wire mechanics. Am J Orthod Dentofacial Orthop 105:350–361

    PubMed  Google Scholar 

  37. Harris EF, Kineret SE, Tolley EA (1997) A heritable component for external apical root resorption in patients treated orthodontically. Am J Orthod Dentofacial Orthop 111:301–309

    PubMed  Google Scholar 

  38. Stanley AA (1996) Levels of root resorption associated with continuous arch and sectional arch mechanics. Am J Orthod Dentofacial Orthop 110:321–324

    Google Scholar 

  39. Blake M, Woodside DG, Pharoah MJ (1995) A radiographic comparison of apical root resorption after orthodontic treatment with the edgewise and speed appliances. Am J Orthod Dentofacial Orthop 108:76–84

    PubMed  Google Scholar 

  40. Linge L, Linge BO (1991) Patient characteristics and treatment variables associated with apical root resorption during orthodontic treatment. Am J Orthod Dentofacial Orthop 99:35–43

    PubMed  Google Scholar 

  41. Mirabella AD, Artun J (1995) Prevalence and severity of apical root resorption of maxillary anterior teeth in adult orthodontic patients. Eur J Orthod 17:93–99

    PubMed  Google Scholar 

  42. Remington DN, Joondeph DR, Artun J, Riedel RA, Chapko MK (1989) Long-term evaluation of root resorption occurring during orthodontic treatment. Am J Orthod Dentofacial Orthop 96:43–46

    PubMed  Google Scholar 

  43. Sameshima GT, Sinclair PM (2001) Predicting and preventing root resorption: Part I. Diagnostic factors. Am J Orthod Dentofacial Orthop 119:505–510

    PubMed  Google Scholar 

  44. Sameshima GT, Asgarifar KO (2001) Assessment of root resorption and root shape: periapical vs panoramic films. Angle Orthod 71:185–189

    PubMed  Google Scholar 

  45. Segal GR, Schiffman PH, Tuncay OC (2004) Meta analysis of the treatment-related factors of external apical root resorption. Orthod Craniofac Res 7:71–78

    PubMed  Google Scholar 

  46. Kjaer I (1995) Morphological characteristics of dentitions developing excessive root resorption during orthodontic treatment. Eur J Orthod 17:25–34

    PubMed  Google Scholar 

  47. Horiuchi A, Hotokezaka H, Kobayashi K (1998) Correlation between cortical plate proximity and apical root resorption. Am J Orthod Dentofacial Orthop 114:311–318

    PubMed  Google Scholar 

  48. Spurrier SW, Hall SH, Joondeph DR, Shapiro PA, Riedel RA (1990) A comparison of apical root resorption during orthodontic treatment in endodontically treated and vital teeth. Am J Orthod Dentofacial Orthop 97:130–134

    PubMed  Google Scholar 

  49. Parker RJ, Harris EF (1998) Directions of orthodontic tooth movements associated with external apical root resorption of the maxillary central incisor. Am J Orthod Dentofacial Orthop 114:677–683

    PubMed  Google Scholar 

  50. Jiang RP, McDonald JP, Fu MK (2010) Root resorption before and after orthodontic treatment: a clinical study of contributory factors. Eur J Orthod 32:693–697

    PubMed  Google Scholar 

  51. Kurol J, Owman-Moll P, Lundgren D (1996) Time-related root resorption after application of a controlled continuous orthodontic force. Am J Orthod Dentofacial Orthop 110(3):303–310

    PubMed  Google Scholar 

  52. Jiang F, Chen J, Kula K, Gu H, Du Y, Eckert G (2017) Root resorptions associated with canine retraction treatment. Am J Orthod Dentofacial Orthop 152:348–354

    PubMed  PubMed Central  Google Scholar 

  53. Weltman B, Vig KW, Fields HW, Shanker S, Kaizar EE (2010) Root resorption associated with orthodontic tooth movement: a systematic review. Am J Orthod Dentofacial Orthop 137:462–476

    PubMed  Google Scholar 

  54. Aman C, Azevedo B, Bednar E, Chandiramami S, German D, Nicholson E et al (2018) Apical root resorption during orthodontic treatment with clear aligners: a retrospective study using cone-beam computed tomography. Am J Orthod Dentofacial Orthop 153:842–851

    PubMed  Google Scholar 

  55. Schwarz AM (1932) Tissue changes incidental to orthodontic tooth movement. Int J Orthod Oral Surg Radiogr 18:331–352

    Google Scholar 

  56. Roscoe MG, Meira JB, Cattaneo PM (2015) Association of orthodontic force system and root resorption: a systematic review. Am J Orthod Dentofacial Orthop 147:610–626

    PubMed  Google Scholar 

  57. Cattaneo P, Dalstra M, Melsen B (2009) Strains in periodontal ligament and alveolar bone associated with orthodontic tooth movement analyzed by finite element. Orthod Craniofac Res 12:120–128

    PubMed  Google Scholar 

  58. Reitan K (1974) Initial tissue behavior during apical root resorption. Angle Orthod 44:68–82

    PubMed  Google Scholar 

  59. Stramotas S, Geenty JP, Petocz P, Darendeliler MA (2002) Accuracy of linear and angular measurements on panoramic radiographs taken at various positions in vitro. Eur J Orthod 24:43–52

    PubMed  Google Scholar 

Download references

Funding

This study was supported by the Başkent University Research Fund.

Author information

Authors and Affiliations

  1. School of Dentistry, Department of Orthodontics, Başkent University, 06490, Ankara, Turkey

    Hande Pamukçu

  2. Private Practice and School of Dentistry, Department of Orthodontics, Başkent University, Ankara, Turkey

    Ömür Polat-Özsoy

  3. School of Dentistry, Department of Dentomaxillofacial Radiology, Başkent University, Ankara, Turkey

    Ayşe Gülşahi & Mehmet Özgür Özemre

Authors
  1. Hande Pamukçu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ömür Polat-Özsoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ayşe Gülşahi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mehmet Özgür Özemre
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hande Pamukçu.

Ethics declarations

Conflict of interest

H. Pamukçu, Ö. Polat-Özsoy, A. Gülşahi and M.Ö. Özemre declare that they have no competing interests.

Ethical standards

This study was approved by Başkent University Institutional Review Board (protocol number: D‑KA 17/ 03). Written informed consent of the patients were present in patients’ file as a regular procedure.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pamukçu, H., Polat-Özsoy, Ö., Gülşahi, A. et al. External apical root resorption after nonextraction orthodontic treatment with labial vs. lingual fixed appliances. J Orofac Orthop 81, 41–51 (2020). https://doi.org/10.1007/s00056-019-00201-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00056-019-00201-w

Keywords

Schlüsselwörter

Search

Navigation