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      Apical root resorption caused by orthodontic forces: A brief review and a long-term observation

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          Abstract

          External apical root resorption (ARR) is a common iatrogenic consequence of orthodontic treatment. One of the aims of this article is to present a brief overview of the literature, including; diagnosis and etiology, with emphasis on orthodontic forces to facilitate an understand of the prevention or management of ARR in orthodontic patients. We also present a long-term follow-up observation of severe ARR, including the last obtained cone beam computed tomography (CBCT) records, to demonstrate the effect of orthodontic forces on ARR.

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          Most cited references33

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          Root resorption associated with orthodontic tooth movement: a systematic review.

          This systematic review evaluated root resorption as an outcome for patients who had orthodontic tooth movement. The results could provide the best available evidence for clinical decisions to minimize the risks and severity of root resorption. Electronic databases were searched, nonelectronic journals were hand searched, and experts in the field were consulted with no language restrictions. Study selection criteria included randomized clinical trials involving human subjects for orthodontic tooth movement, with fixed appliances, and root resorption recorded during or after treatment. Two authors independently reviewed and extracted data from the selected studies on a standardized form. The searches retrieved 921 unique citations. Titles and abstracts identified 144 full articles from which 13 remained after the inclusion criteria were applied. Differences in the methodologic approaches and reporting results made quantitative statistical comparisons impossible. Evidence suggests that comprehensive orthodontic treatment causes increased incidence and severity of root resorption, and heavy forces might be particularly harmful. Orthodontically induced inflammatory root resorption is unaffected by archwire sequencing, bracket prescription, and self-ligation. Previous trauma and tooth morphology are unlikely causative factors. There is some evidence that a 2 to 3 month pause in treatment decreases total root resorption. The results were inconclusive in the clinical management of root resorption, but there is evidence to support the use of light forces, especially with incisor intrusion. Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
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            Orthodontically induced inflammatory root resorption. Part I: The basic science aspects.

            Orthodontically induced inflammatory root resorption (OIIRR) or, as it is better known, root resorption, is an unavoidable pathologic consequence of orthodontic tooth movement. It is a certain adverse effect of an otherwise predictable force application. Although it is rarely serious, it is a devastating event when it is radiographically recognized. Orthodontics is probably the only dental specialty that actually uses the inflammatory process as a means of solving functional and esthetic problems. Force application initiates a sequential cellular process. We know exactly how and when it is evoked, but we are unable to predict its actual overall outcome. The extent of this inflammatory process depends on many factors such as the virulence or aggressiveness of the different resorbing cells, as well as the vulnerability and sensitivity of the tissues involved. Individual variation and susceptibility, which are related to this process, remain beyond our understanding. We are therefore unable to predict the incidence and extent of OIIRR after force application. This contemporary review is divided into two parts. In Part I, we discuss the basic sciences aspects of OIIRR as a continuation of our previously published work. In Part II, we present the clinical aspects of this subject.
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              Detection of apical root resorption after orthodontic treatment by using panoramic radiography and cone-beam computed tomography of super-high resolution.

              Apical root resorption is an adverse side effect of orthodontic treatment. We compared panoramic radiography (OPT) with cone-beam computed tomography (CBCT) in evaluating orthodontically induced apical root resorption. The study sample comprised 275 teeth in 22 patients near the end of orthodontic treatment with fixed appliances. Two calibrated examiners assessed blindly the presence or absence and the severity of apical root resorption on the OPT images after treatment and the corresponding reconstructed CBCT images. Resorption was evaluated as no, mild, moderate, severe, and extreme. On the OPT images, 17 teeth (6.2%) could not be evaluated. Statistically significant differences were found between the 2 methods: 56.5% and 31% of the teeth showed no resorption by OPT and CBCT, respectively; 33.5% and 49% of the teeth showed mild resorption, whereas 8% and 19% showed moderate resorption by OPT and CBCT, respectively. Severe resorption was found in only 2 teeth by CBCT. Apical root resorption after orthodontic tooth movement is underestimated when evaluated on OPT. CBCT might be a useful complementary diagnostic method to conventional radiography, to be applied when a decision on continuation or modification of the orthodontic treatment is necessary because of orthodontically induced root resorption.
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                Author and article information

                Journal
                Eur J Dent
                Eur J Dent
                Eur J Dent
                European Journal of Dentistry
                Dental Investigations Society
                1305-7456
                1305-7464
                October 2012
                : 6
                : 4
                : 445-453
                Affiliations
                [1 ]Private practice, Orthoclinic, Alanya, TURKIYE
                [2 ]Department of Orthodontics, Kocaeli University, Kocaeli, TURKIYE
                [3 ]Department of Orthodontics, University of Alabama, Birmingham, Alabama, USA
                Author notes
                Corresponding author: Dr. Ahu Topkara, Gullerpinari Mah. E. Kahvecioglu Cad. No:6/2 07400, Alanya TURKIYE, Tel/Fax: +90 242 5136043, Email: ahutopkara@ 123456gmail.com
                Article
                dent6_p0445
                3474562
                23077427
                14b0fbd8-d936-402c-801e-b6f6da02821c
                Copyright 2012 European Journal of Dentistry. All rights reserved.
                History
                Categories
                Articles

                Dentistry
                root resorption,orthodontic treatment,follow- up case,orthodontic forces
                Dentistry
                root resorption, orthodontic treatment, follow- up case, orthodontic forces

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