Skip to main content
SpringerLink
Log in

Severe external apical root resorption—local cause or genetic predisposition?

Schwergradige apikale Wurzelresorption – lokale Ursache oder genetische Prädisposition?

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

Abstract

Background

Current data suggest that a large extent of the variation in orthodontic root resorption may be explained by differences in individual genetic predisposition. This would imply, however, a similar root resorption reaction in all teeth.

Objective

To determine the incidence and extent of severe external apical root resorptions (SEARR) in maxillary incisors during multibracket (MB) appliance treatment.

Patients and methods

Of the whole sample of patients having completed MB treatment at the University of Giessen between 1991 and 2010 (PTotal=3198), all subjects exhibiting severe root resorptions on at least one maxillary incisor were selected. SEARR were defined according to Malmgren et al. [39] (grade-IV RR=resorption >1/3 root length). Evaluation was performed using orthopantomograms from before and after MB treatment. The crown and root length of the affected teeth were measured. The extent of SEARR was assessed taking pretreatment crown length into consideration.

Results

SEARR was detected in 16 patients. Thus, the incidence of SEARR on maxillary incisors during MB treatment totalled 0.5%. The median of SEARR of the affected incisors was 38.6% of the initial root length (minimum=33.4%, maximum=61.0%). Most subjects exhibited only single affected teeth. Only two subjects (0.06% absolute/12.5% relative) presented four maxillary incisors with SEARR.

Conclusions

The incidence of SEARR on maxillary incisors during MB treatment (0.5%) was very low compared to the literature. With only 12.5% of SEARR patients presenting four affected teeth, local rather than systemic/genetic factors seem to have predisposed the present subjects to SEARR.

Zusammenfassung

Hintergrund

Aktuelle Studien lassen vermuten, dass ein Großteil kieferorthopädisch verursachter Wurzelresorptionen auf eine unterschiedliche genetische Prädisposition der Patienten zurückzuführen ist. Dies ließe jedoch eine prinzipiell ähnliche Wurzelresorptionsreaktion aller Zähne erwarten.

Ziel

Ermittlung der Inzidenz und des Ausmaßes schwergradiger Wurzelresorptionen (SWR) an Oberkiefer(OK)-Inzisivi, die während der Behandlung mit einer Multibracketapparatur (MB) auftraten.

Patienten und Methodik

Das gesamte Patientengut der Jahre 1991 bis 2010 der Poliklinik für Kieferorthopädie Gießen wurde auf Patienten hin untersucht, die mit MB behandelt worden waren (PTotal=3198). Ferner musste sich während der Behandlung eine SWR gemäß Malmgren et al. ([39]; WR Grad IV=WR >1/3 der ursprünglichen Wurzellänge) mindestens eines OK-Inzisivus entwickelt haben. Die SWR-Diagnose erfolgte anhand von Orthopantomogrammen der Zeitpunkte vor und nach MB. Kronen- und Wurzellänge aller betroffenen OK-Inzisivi wurden gemessen und die relative Wurzellängenreduktion unter Berücksichtigung der prätherapeutischen Kronenlänge ermittelt.

Ergebnisse

SWR an OK-Inzisivi nach MB-Behandlung zeigten sich bei 16 Patienten, d. h. die Inzidenz betrug 0,5%. Der Median der WR betroffener OK-Inzisivi lag bei 38,6% der ursprünglichen Wurzellänge (Min=33,4%, Max=61,0%). Die Mehrzahl der Patienten wies nur einen betroffenen Zahn auf. Lediglich bei 2 Patienten (0,06% absolut/12,5% relativ) waren 4 OK-Inzisivi von SWR betroffen.

Schlussfolgerungen

Die Inzidenz von SWR an OK-Inzisivi während MB-Behandlung (0,5%) war im Vergleich zur Literatur niedrig. Da nur 12,5% der SWR-Patienten 4 betroffene Zähne aufwiesen, liegt die Vermutung nahe, dass im vorliegenden Patientengut eher eine lokale als eine systemische bzw. genetische Ursache für die Entstehung der SWR ausschlaggebend war.

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
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  3. Al-Qawasmi RA, Hartsfield JK Jr, Everett ET et al (2003b) Genetic predisposition to external apical root resorption in orthodontic patients: linkage of chromosome-18 marker. J Dent Res 82:356–360

    Article  PubMed  Google Scholar 

  4. Al-Qawasmi RA, Hartsfield JK Jr, Everett ET et al (2006) Root resorption associated with orthodonric force in inbred mice: genetic contributions. Eur J Orthod 28:13–19

    Article  PubMed  Google Scholar 

  5. Artun J, Van ‘t Hullenaar R, Doppel D, Kuijpers-Jagtman AM (2009) Identification of orthodontic patients at risk of severe apical root resorption. Am J Orthod Dentofacial Orthop 135:448–455

    Article  PubMed  Google Scholar 

  6. Bastos Lages EM, Drummond AF, Pretti H et al (2009) Association of functional gene polymorphism IL-1b in patients with external apical root resorption. Am J Orthod Dentofacial Orthop 136:542–546

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  11. Casa MA, Faltin RM, Faltin K et al (2001) Root resorptions in upper first premolars after application of continuous torque moment. Intra-individual study. J Orofac Orthop 62:285–295

    Article  PubMed  Google Scholar 

  12. Cheng LL, Türk T, Elekdag-Türk S et al (2010) 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 138:727–734

    Article  PubMed  Google Scholar 

  13. Costopoulos G, Nanda R (1996) An evaluation of root resorption incident to orthodontic intrusion. Am J Orthod Dentofacial Orthop 109:543–548

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  15. Gonzales C, Hotokezaka H, Yoshimatsu M et al (2008) Force magnitude and duration effects on amount of tooth movement and root resorption in the rat molar. Angle Orthod 78:502–509

    Article  PubMed  Google Scholar 

  16. Göz G, Rakosi T (1989) Die apikale Wurzelresorption unter kieferorthopädischer Behandlung. Fortschr Kieferorthop 50:196–206

    Article  PubMed  Google Scholar 

  17. Gülden N, Eggermann T, Zerres K et al (2009) Interleukin-1 polymorphisms in relation to external apical root resorption (EARR). J Orofac Orthop 70:20–38

    Article  PubMed  Google Scholar 

  18. Harris EF, Boggan BW, Wheeler DA (2001) Apical root resorption in patients treated with comprehensive orthodontics. J Tenn Dent Assoc 81:30–33

    PubMed  Google Scholar 

  19. 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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  21. Janson GRP, Luca Canto G de, Martins DR et al (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

    Article  PubMed  Google Scholar 

  22. Jönsson A, Malmgren O, Levander E (2007) Long-term follow-up of tooth mobility in maxillary incisors with orthodontically induced apical root resorption. Eur J Orthod 29:482–487

    Article  PubMed  Google Scholar 

  23. Kaley J, Phillips C (1991) Factors related to root resorption in edgewise practice. Angle Orthod 61:125–132

    PubMed  Google Scholar 

  24. Ketcham AH (1927) A preliminary report of an investigation of apical root resorption of permanent teeth. Int J Orthodont 12:97–127

    Google Scholar 

  25. Ketcham AH (1929) A progress report of an investigation of apical root resorption of vital permanent teeth. Int J Orthodont 15:310–328

    Google Scholar 

  26. Killiany DM (1999) Root resorption caused by orthodontic treatment: an evidence based review of literature. Semin Orthod 5:128–133

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  28. Kurol J, Owmann-Moll P (1998) Hyalinization and root resorption during early orthodontic tooth movement in adolescents. Angle Orthod 68:161–165

    PubMed  Google Scholar 

  29. Lee RY, Artun J, Alonzo TA (1999) Are dental anomalies risk factors for apical root resorption in orthodontic patients? Am J Orthod Dentofacial Orthop 116:187–195

    Article  PubMed  Google Scholar 

  30. Levander E, Malmgren O (1988) Evaluation of the risk of root resorption during orthodontic treatment: a study of upper incisors. Eur J Orthod 10:30–38

    PubMed  Google Scholar 

  31. Levander E, Malmgren O (1997) Early radiographic diagnosis of apical root resorption during orthodontic treatment: a study of maxillary incisors. Eur J Orthod 20:57–63

    Article  Google Scholar 

  32. Levander E, Malmgren O (2000) Long-term follow-up of maxillary incisors with severe apical root resorption. Eur J Orthod 22:85–92

    Article  PubMed  Google Scholar 

  33. 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

    Article  PubMed  Google Scholar 

  34. Linge BO, Linge L (1980) Apikale Wurzelresorptionen der oberen Frontzähne. Fortschr Kieferorthop 41:276–288

    Article  Google Scholar 

  35. Linge BO, Linge L (1983) Apical root resorption in upper anterior teeth. Eur J Orthod 5:173–183

    PubMed  Google Scholar 

  36. 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

    Article  PubMed  Google Scholar 

  37. Loenen M van, Dermaut LR, Degrieck J, De Pauw GA (2007) Apical root resorption of upper incisors during the torquing stage of the tip-edge technique. Eur J Orthod 29:583–588

    Article  PubMed  Google Scholar 

  38. Lupi JE, Handelmann 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

    Article  PubMed  Google Scholar 

  39. Malmgren O, Goldson L, Hill C et al (1982) Root resorption after orthodontic treatment of traumatized teeth. Am J Orthop 82:487–491

    Article  Google Scholar 

  40. Mavragani M, Vergari A, Selliseth NJ et al (2000) A radiographic comparison of apical root resorption after orthodontic treatment with standard edgewise and straight-wire edgewise technique. Eur J Orthod 22:665–674

    Article  PubMed  Google Scholar 

  41. Melsen B (2001) Tissue reaction to orthodontic tooth movement—a new paradigm. Eur J Orthod 23:671–681

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  44. Mohandesan H, Ravanmehr H, Valaei N (2007) A radiographic analysis of external apical root resorption of maxillary incisors during active orthodontic treatment. Eur J Orthod 29:134–139

    Article  PubMed  Google Scholar 

  45. Newman WG (1975) Possible etiologic factors in external root resorption. Am J Orthop 67:522–539

    Article  Google Scholar 

  46. Owmann-Moll P, Kurol J, Lundgren D (1995) Repair of orthodontically induced root resorption in adolescents. Angle Orthod 65:403–410

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  48. Phillips JR (1995) Apical root resorption under orthodontic therapy. Angle Orthod 25:1–22

    Google Scholar 

  49. Ren Y, Maltha JC, Kuijpers-Jagtman AM (2003) Optimum force magnitude for orthodontic tooth movement: a systematic literature review. Angle Orthod 73:86–92

    PubMed  Google Scholar 

  50. Remington DN, Joondeph DR, Artun J et al (1989) Long-term evaluation of root resorption occurring during orthodontic treatment. Am J Orthod Dentofacial Orthop 96:43–46

    Article  PubMed  Google Scholar 

  51. Rudolph CE (1936) A comparative study in root resorption in permanent teeth. J Am Dent Assoc 23:822–826

    Google Scholar 

  52. Rupp R (1995) Root resorption related to orthodontics and other factors: a review of the literature. J Gen Orthod 6:25–29

    PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  54. Sameshima GT, Sinclair PM (2001b) Predicting and preventing root resorption: Part II. Treatment factors. Am J Orthod Dentofacial Orthop 119:511–515

    Article  PubMed  Google Scholar 

  55. Sameshima GT, Sinclair PM (2004) Characteristics of patients with severe root resorption. Orthod Craniofac Res 7:108–114

    Article  PubMed  Google Scholar 

  56. Vlaskalic V, Boyd RL, Baumrind S (1998) Etiology and sequelae of root resorption. Semin Orthod 4:124–131

    Article  PubMed  Google Scholar 

  57. Wehrbein H, Harhoff R, Diedrich P (1990) Wurzelresorptionsrate bei orthodontisch bewegten, parodontal geschädigten und gesunden Zähnen. Dtsch Zahnarztl Z 45:176–178

    PubMed  Google Scholar 

  58. Wehrbein H, Fuhrmann RA, Diedrich RP (1994) Periodontal conditions after facial root tipping and palatal root torque of incisors. Am J Orthod Dentofacial Orthop 106:455–462

    Article  PubMed  Google Scholar 

  59. Weiland F (2003) Constant versus dissipating forces in orthodontics: the effect on initial tooth movement and root resorption. Eur J Orthod 25:335–342

    Article  PubMed  Google Scholar 

  60. Weiland F, Droschl H (2006) Kieferorthopädische Wurzelresorptionen – ein langfristiger Ausblick. Inf Orthod Kieferorthop 38:1–5

    Article  Google Scholar 

  61. Zhang D, Goetz W, Braumann B et al (2003) Effect of soluble receptors to interleukin-1 and tumor necrosis factor alpha on experimentally induced root resorption in rats. J Periodontal Res 38:324–332

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None declared

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Department of Orthodontics, Medical Center for Dental and Oral Medicine, Justus Liebig University, Schlangenzahl 14, 35392, Giessen, Germany

    K. Sehr, N.C. Bock, M. Hönemann &  S. Ruf

  2. Private Practice, Limburg, Germany

    C. Serbesis

Authors
  1. K. Sehr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N.C. Bock
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Serbesis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Hönemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Ruf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Ruf.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sehr, K., Bock, N., Serbesis, C. et al. Severe external apical root resorption—local cause or genetic predisposition?. J Orofac Orthop 72, 321–331 (2011). https://doi.org/10.1007/s00056-011-0036-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00056-011-0036-1

Keywords

Schlüsselwörter

Search

Navigation