Korean J Orthod.  2019 Sep;49(5):310-318. 10.4041/kjod.2019.49.5.310.

Predisposing factors for external apical root resorption associated with orthodontic treatment

Affiliations
  • 1Department of Orthodontics, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil. jonascapelli@gmail.com
  • 2Department Of Orthodontics, School Of Dentistry, Pontifical Catholic University Of Minas Gerais, Belo Horizonte, Brazil.
  • 3Department of Cell Biology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • 4Department of Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.

Abstract


OBJECTIVE
This study aimed to identify possible risk factors for external apical root resorption (EARR) in the maxillary incisors after orthodontic treatment.
METHODS
The root length of 2,173 maxillary incisors was measured on periapical radiographs of 564 patients who received orthodontic treatment. The Kappa test was performed to evaluate intraexaminer and interexaminer reproducibility. Multiple binary logistic regression was used to determine the association between EARR and various factors. Odds ratios and 95% confidence intervals were reported.
RESULTS
The risk of developing EARR was 70% higher in orthodontic treatment with maxillary premolar extraction (p = 0.004), 58% higher in patients with increased overjet (p = 0.012), 41% lower in two-phase orthodontic treatment (p = 0.037), and 33% lower in patients with deep bite (p = 0.039). The lateral incisors were 54% more likely to develop EARR (p < 0.001), dilacerated roots were 2.26 times more likely to develop EARR (p < 0.001), and for each additional millimeter of root length, the risk of EARR increased by 29% (p < 0.001).
CONCLUSIONS
The potential risk factors for EARR after orthodontic treatment included treatment with maxillary premolar extraction, increased overjet at the beginning of treatment, and dilacerated roots.

Keyword

Root resorption; Orthodontic treatment; Incisor

MeSH Terms

Bicuspid
Causality*
Humans
Incisor
Logistic Models
Odds Ratio
Overbite
Risk Factors
Root Resorption*

Figure

  • Figure 1 Initial root shape classification.

  • Figure 2 References to the measurement of external apical root resorption in rhomboid, triangular, pipette (A), and dilacerated roots (B). RA, Root apex; M, mesial point of the cementoenamel junction (CEJ); D, distal point of the CEJ; C, central point of the line joining M and D; IE, central point of the incisal edge; I, point of intersection between the long axis of the tooth, from C, and the long axis of the dilacerated root portion, from the RA; R1, the root length before treatment; R2, the root length after treatment; C1, the crown length before treatment; C2, the crown length after treatment; Measurement 1, distance from point C to I; Measurement 2, distance from point I to the RA.

  • Figure 3 Frequency of the central and lateral incisors affected by external apical root resorption.

  • Figure 4 Frequency of external apical root resorption according to the initial root shape.


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