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Root resorption in Class II malocclusion treatment with and without maxillary premolar extractions. Am J Orthod Dentofacial Orthop 2023; 163:389-397. [PMID: 36476368 DOI: 10.1016/j.ajodo.2021.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Class II malocclusion treatment efficiency with maxillary premolar extractions has been reported. However, no study evaluated the root resorption associated with this protocol. Therefore, this study aimed to compare the degree of root resorption of the maxillary incisors in Class II malocclusion treatment with and without maxillary premolar extractions. METHODS The sample consisted of 56 patients with complete Class II malocclusion, divided into 2 groups. Group 1 comprised 28 patients (10 female, 18 male) treated with maxillary first premolar extractions, and group 2 was composed of 28 patients (16 female, 12 male) treated without extractions. The groups were matched regarding initial age, treatment time, crowding, initial malocclusion severity, finishing quality, initial overjet, and overbite. Periapical radiographs of the maxillary incisors were used to assess the degree of root resorption using a scoring system. In addition, treatment changes involving maxillary incisors were evaluated in lateral headfilms. Intergroup comparisons were performed with t, Mann-Whitney U, and chi-square tests (P <0.05). RESULTS Overjet, overbite, inclination, vertical positional changes, and vertical and horizontal apical displacements of maxillary incisors were similar between groups. There was no statistically significant difference between groups regarding root resorption of maxillary incisors. Root resorption degree ranged from mild to moderate in both groups. CONCLUSIONS Treating complete Class II malocclusion with 2 maxillary premolar extractions resulted in a similar root resorption as treating without maxillary premolar extractions. An individualized evaluation of root resorption predisposing factors should be performed for each patient.
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Orthodontically Induced External Apical Root Resorption in Class II Malocclusion. Case Rep Dent 2022; 2021:8290429. [PMID: 34976417 PMCID: PMC8716209 DOI: 10.1155/2021/8290429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/17/2021] [Accepted: 11/23/2021] [Indexed: 12/02/2022] Open
Abstract
Orthodontic-induced external apical root resorption is one of the idiopathic phenomena as an effect, with force generated through mechanotherapy as the cause and the biological tissues with their diversified variations as witness. It is also classified as iatrogenic as a result of indeterminate application of orthodontic forces with subconscious appreciation of the existing underlying conditions. Numerous factors were identified to relate to this irreversible pathologic condition, but none were proven scientifically. Genetics and salivary markers have proved the reliability with time, but the application became insignificant limiting mostly to the research field. Different assessment methods were also identified to clinically diagnose it both subjectively and objectively. Mostly, it is identified through routine radiographic stage records like orthopantomogram or certain prediction radiographs for root resorption probability assessment like in this case. This case report discusses one such encounter which was experienced after stage 1 and 2 mechanics involving quite a few teeth. Considering the biotype of the individual and tooth morphology, the ongoing treatment was terminated and recovery measures were briefed to uplift the self-esteem of the individual. Furthermore, the prognosis is compromised to be very poor with unpredictability to any other treatment modalities.
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Kawamura J, Park JH, Kojima Y, Tamaya N, Kook YA, Kyung HM, Chae JM. Biomechanical analysis for total distalization of the maxillary dentition: A finite element study. Am J Orthod Dentofacial Orthop 2021; 160:259-265. [PMID: 33972141 DOI: 10.1016/j.ajodo.2020.04.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/01/2020] [Accepted: 04/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aimed to identify the tooth movement patterns relative to various force angulations (FAs) when distalizing the total maxillary dentition. METHODS Long-term orthodontic movement of the maxillary dentition was simulated by accumulating the initial displacement of teeth produced by elastic deflection of the periodontal ligament using a finite element analysis. Distalization forces of 3 N were applied to the archwire between the maxillary canine and first premolar at 5 different FAs (-30°, -15°, 0°, 15°, and 30°) to the occlusal plane. RESULTS Maxillary incisors and molars showed lingual and distal tipping at all FAs, respectively. At a force angulation of 30°, almost bodily distalization of the total maxillary dentition occurred, but incisors showed considerable lingual tipping because of the effect of clearance gap (0.003-in, 0.022 × 0.025-in bracket slot, 0.019 × 0.025-in archwire) and elastic deflection of the archwire. Medial displacement of the maxillary anterior teeth occurred because of lingual tipping during distalization. The occlusal plane rotated clockwise at all FAs because of extrusion of the maxillary incisors and intrusion of the maxillary second molars, and the amounts decreased as FA increased. CONCLUSIONS Tooth movement patterns during distalization of the total maxillary dentition were recognized. With an understanding of the mechanics, a proper treatment plan can be established.
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Affiliation(s)
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, Ariz, Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | | | | | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Jong-Moon Chae
- Department of Orthodontics, School of Dentistry, Wonkwang University, Wonkwang Dental Research Institute, Iksan, South Korea, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, Ariz.
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Effects of maxillary incisor inclination on dentoalveolar changes in class II division 1 and 2 non-extraction treatment for Caucasian children - A retrospective study using CBCT. Int Orthod 2020; 19:51-59. [PMID: 33309514 DOI: 10.1016/j.ortho.2020.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/31/2020] [Accepted: 11/12/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the effects of maxillary central incisor (U1) inclination changes on alveolar bone and root length in the 20 Class II division 1 and 20 Class II division 2 (CII div1, CII div2) Caucasian adolescents treated without extraction. MATERIAL AND METHODS Forty U1s from each group were assessed for root length and alveolar variables at the crestal, mid-root, and apical levels using sagittal sections obtained from CBCT images pre- and post-treatment. Mixed MANOVAs, Repeated measures MANOVAs, Pearson correlations, and regression analyses were performed. RESULTS The facial bone height did not change significantly after an average of 15 degrees of proclination in the CII div2 group, whereas a statistically significant decrease in the palatal bone height was noted. However, in the CII div1 group, a statistically significant reduction in the facial and palatal bone height was observed with mild crown retroclination. Both groups had a significant decrease in total bone thickness at all levels, more decrease in the CII div2 group after treatment. No statistically significant difference in root length was observed between the groups during treatment. CONCLUSIONS The findings support that the flaring of retroclined U1s as a process for normalizing U1 inclination did not harm the facial alveolar bone height in the CII div2 non-extraction treatment. Crown proclination itself was not correlated to the amount of root resorption in Class II div1&2 non-extraction treatments in adolescents.
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Johansson K, Lindh C, Paulsson L, Rohlin M. A tool for assessment of risk of bias in studies of adverse effects of orthodontic treatment applied in a systematic review on external root resorption. Eur J Orthod 2020; 43:457-466. [PMID: 33215631 DOI: 10.1093/ejo/cjaa072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND AIMS Systematic reviews (SRs) are considered to provide reliable estimates, but flaws in designs, methods of monitoring effects, and outcomes have the potential to bias results. There are several tools for assessing risk of bias (RoB), most of them designed for SRs of beneficial effects. To our knowledge, there is no tool that is adapted specifically to assess RoB in studies of adverse effects associated with orthodontic treatment. To address this, the aim of this study was first to introduce a tool for assessment of RoB in studies of adverse effects associated with orthodontic treatment and, second, to apply it in an SR of external root resorption (ERR) associated with orthodontic treatment with fixed appliance. MATERIALS AND METHODS The approach with domains supported by signalling questions was used for the tool. Domains and signalling questions were tailored to the review questions of the SR of studies of ERR after orthodontic treatment using periapical radiography or cone beam computed tomography. Duplicate study selection, data extraction, and RoB assessment using the tool, followed by meta-analyses, were performed. RESULTS Using the tool for the assessment of RoB identified shortcomings and report deficiencies of primary studies concerning the presentation of orthodontic treatment, identification of ERR, and analysis of outcomes. RoB assessment resulted in 12 of 32 studies read in full text being included. Reported severe ERR varied across studies between 2 and 14 per cent for all incisors and 10 and 29 per cent for maxillary incisors. Results of ERR related to patients' age and sex, orthodontic diagnosis, and treatment were contradictory. Quality of evidence evaluated by GRADE was low due to study limitations, imprecision, and inconsistency of study results. CONCLUSIONS As the tool and its application highlight important issues to consider when planning, conducting, and reporting research, the tool may have a valuable role for quality enhancement of future studies of outcomes of orthodontic treatment. The tool may also serve for authors when planning SRs. Our SR identified a need for studies that use rigorous methodology and transparent reporting. REGISTRATION PROSPERO (ID = CRD42018084725).
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Meriç P, Zortuk FB, Karadede MI. Volumetric measurements of mandibular incisor root resorption following Forsus FRD EZ2 and Bionator appliance treatment using cone-beam computed tomography: A preliminary study. APOS TRENDS IN ORTHODONTICS 2020. [DOI: 10.25259/apos_7_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
Root resorption is one of the frequently encountered problems in orthodontic treatments. The effects of functional appliances on root resorption have not been clearly demonstrated. The aim of this study was to compare volumetric root resorption of mandibular incisors after Bionator and Forsus appliance treatment using cone-beam computed tomography (CBCT).
Materials and Methods:
The study sample (n = 30) was selected from Class II div. 1 mandibular retrognathia patients treated with the Bionator and Forsus appliances. The first CBCT scans were taken before Bionator use and after 6 months. In the Forsus group, the first CBCT scans were taken before Forsus appliance use and after an overcorrected Class I relationship was obtained. The mean treatment time with the Forsus appliance was 5 ± 1.2 months. Mimics software was used for segmentation and volumetric measurements of mandibular incisor teeth root resorption.
Results:
In the Bionator group, statistically significant root volume loss was not found. In the Forsus group, the differences between before and after the treatment were not statistically significant for teeth 41, 31, and 32 (P > 0.05), whereas the difference was statistically significant for the lower right second incisor (P < 0.002). The percentage of volume loss (%) and root volume loss (mm3) was not statistically significant between groups.
Conclusions:
Following functional treatment with the Bionator and Forsus, statistically significant difference was not found between groups for mandibular incisor root resorption.
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Affiliation(s)
- Pamir Meriç
- Department of Orthodontics, Trakya University, Edirne,
| | | | - M. Irfan Karadede
- Department of Orthodontics, Izmir Katip Celebi University, Izmir, Turkey,
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Kawamura J, Park JH, Kojima Y, Kook Y, Kyung H, Chae J. Biomechanical analysis for total mesialization of the mandibular dentition: A finite element study. Orthod Craniofac Res 2019; 22:329-336. [DOI: 10.1111/ocr.12331] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/09/2019] [Accepted: 06/15/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Jun Kawamura
- Private Practice in Kawamura Dental Office Gifu Japan
| | - Jae Hyun Park
- Postgraduate Orthodontic Program Arizona School of Dentistry & Oral Health, A.T. Still University Mesa Ariz
- Graduate School of Dentistry Kyung Hee University Seoul Korea
| | | | - Yoon‐Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital Catholic University of Korea Seoul Korea
| | - Hee‐Moon Kyung
- Department of Orthodontics, School of Dentistry Kyungpook National University Daegu Korea
| | - Jong‐Moon Chae
- Postgraduate Orthodontic Program Arizona School of Dentistry & Oral Health, A.T. Still University Mesa Ariz
- Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute University of Wonkwang Iksan Korea
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Aman C, Azevedo B, Bednar E, Chandiramami S, German D, Nicholson E, Nicholson K, Scarfe WC. Apical root resorption during orthodontic treatment with clear aligners: A retrospective study using cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2018; 153:842-851. [PMID: 29853242 DOI: 10.1016/j.ajodo.2017.10.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/01/2017] [Accepted: 10/01/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION We aimed to investigate the incidence and severity of orthodontically induced inflammatory root resorption (OIIRR) on maxillary incisors with clear aligner therapy using cone-beam computed tomography and to identify possible risk factors. METHODS The root lengths of maxillary incisors were measured on orthogonal images from pretreatment and posttreatment cone-beam computed tomography examinations of 160 patients who received comprehensive orthodontic treatment with clear aligners. RESULTS Mean absolute reductions in root length varied between 0.47 ± 0.61 mm and 0.55 ± 0.70 mm and were not significantly different between maxillary central and lateral incisors. The prevalence of severe OIIRR, defined as both maxillary central incisors experiencing greater than a 25% reduction in root length, was found to be 1.25%. Potential risk factors included sex, malocclusion, crowding, and posttreatment approximation of apices to the cortical plates. Race, interproximal reduction, previous trauma to the teeth, elastics, age, treatment duration, and pretreatment approximation of apices to the cortical plates did not significantly affect the amount of OIIRR. CONCLUSIONS Comprehensive treatment with clear aligners resulted in minimal root resorption. Sex, malocclusion, crowding, and posttreatment approximation to the cortical plates significantly affected the percentage of change in root length. Posttreatment approximation of root apices to the palatal cortical plate showed the strongest association for increased OIIRR.
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Affiliation(s)
- Courtney Aman
- Department of Orthodontics, University of Louisville, Louisville, Ky.
| | - Bruno Azevedo
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Ky
| | - Eric Bednar
- Department of Orthodontics, University of Louisville, Louisville, Ky; private practice, Louisville, Ky
| | | | - Daniel German
- Department of Orthodontics, Ohio State University, Columbus; private practice, Beavercreek, Ohio
| | - Eric Nicholson
- Department of General Dentistry and Oral Medicine, University of Louisville, Louisville, Ky; private practice, Louisville, Ky
| | - Keith Nicholson
- Department of Orthodontics, University of Louisville, Louisville, Ky; private practice, Louisville, Ky
| | - William C Scarfe
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Ky
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