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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 6  |  Page : 1306-1308  

Root resorption of endodontically treated teeth following orthodontic treatment: A cross-sectional study


1 Department of Conservative Dentistry and Endodontics, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India
2 Department of Orthodontics and Dentofacial Orthopaedics, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India
3 Private Dental Practioner, Ara, Bhojpur, Bihar, India
4 Department of Paediatric and Preventive Dentistry, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India
5 Private Dental Practioner, (Pedodontist), Kishanganj, Bihar, India
6 Private Dental Practioner, Hajipur, Bihar, India

Date of Submission03-Mar-2021
Date of Decision11-Apr-2021
Date of Acceptance09-May-2021
Date of Web Publication10-Nov-2021

Correspondence Address:
Saurav Kumar
Department of Orthodontics and Dentofacial Orthopaedics, Mithila Minority Dental College and Hospital, Darbhanga, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_134_21

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   Abstract 


Background: Root resorption is an unwanted phenomenon occurring in a substantial population proportion these days. Hence, the current study was conducted to evaluate root resorption in endodontically treated teeth following fixed orthodontic treatment. Materials and Methods: A total of 100 patients were enrolled. Only those patients were enrolled that were scheduled to undergo fixed orthodontic therapy. Pretreatment examination was done in all the patients, and their radiographs were obtained. Both orthopantomograms and peri-apical radiographs were taken. All the patients were recalled on follow-up, and radiographic examination was again carried out. Pretreatment radiographs and follow-up radiographs were compared. The incidence of root resorption was documented. The data were entered in an Excel sheet (Microsoft office version 2007) and analyzed using IBM SPSS software version 20. Results: Root resorption was present in 30 patients. Among these 30 patients, 20 were male, whereas 10 were female. In 19 patients, root resorption was present in the maxillary arch, whereas in 11 patients, it was seen in the mandibular arch. The most common tooth involved with root resorption was premolars, followed by anteriors and molars. Conclusion: The risk of root resorption is higher in endodontically treated teeth under the influence of orthodontic forces.

Keywords: Orthodontics, resorption, root


How to cite this article:
Khan RA, Kumar S, Hassan N, Anand B, Mazhar S, Anjan R. Root resorption of endodontically treated teeth following orthodontic treatment: A cross-sectional study. J Pharm Bioall Sci 2021;13, Suppl S2:1306-8

How to cite this URL:
Khan RA, Kumar S, Hassan N, Anand B, Mazhar S, Anjan R. Root resorption of endodontically treated teeth following orthodontic treatment: A cross-sectional study. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Aug 11];13, Suppl S2:1306-8. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1306/329973




   Introduction Top


Resorption of the tooth root is an unwanted phenomenon occurring in a significant proportion of the population. It is a complicated process and is irreversible. It involves cementum's external layers, radicular dentin/apex. It is often regarded as an undesirable adverse effect associated with orthodontic treatment. Significant data published in the past literature have documented the number of cases highlighting orthodontic treatment associated with external tooth resorption. On force application, within the tissues, inflammatory process is initiated causing bone remodelling and root resorption.[1],[2],[3] Root resorption related to the fixed orthodontic treatment can occur because of several factors, like the type and magnitude of orthodontic forces and the duration of treatment. Orthodontic patients who have notable root resorption during the first 6 months of their active treatment are expected to experience resorption in later in the treatment.[4],[5],[6] Hence, in light of the data mentioned above, the current study was undertaken to assess the rate of root resorption in endodontically treated teeth following fixed orthodontic treatment.


   Materials and Methods Top


The current study was done in the Department of Orthodontics and Dentofacial Orthopedics of the Minority Dental College and Hospital. The dental institution approved the ethical clearance for the study. All the patients were explained about the treatment and the study, and their written consent was obtained. A total of 100 patients were enrolled. Only those patients were enrolled that were scheduled to undergo fixed orthodontic therapy and had endodontically restored teeth. Pretreatment examination was done in all the patients, and their radiographs were obtained. Both v and peri-apical radiographs were taken. Treatment planning was done based on diagnostic casts, and fixed orthodontic was started. All the patients were recalled on follow-up, and radiographic examination was again carried out. Pretreatment radiographs and follow-up radiographs were compared. The incidence of root resorption was documented. The data were entered in an Excel sheet analyzed using IBM SPSS (Statistical Package for the Social Sciences, IBM, USA) software version 20.


   Results Top


In the present study, a total of 100 patients were enrolled. The mean age was 15.4 years. Out of 100 patients, root resorption was present in 30 patients. Among these 30 patients, 20 were male, whereas 10 were female. In 19 patients, root resorption was present in the maxillary arch, whereas in 11 patients, it was seen in the mandibular arch. The most common tooth involved with root resorption was premolars, followed by anteriors and molars [Table 1] and [Table 2].
Table 1: Incidence of root resorption

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Table 2: Demographic and clinical data among patients with root resorption

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   Discussion Top


Apical root resorption is usually characterized by rounding the root apex. It is a common sequela of fixed orthodontic treatment. The predisposing factors causing root resorption include endocrine disturbances, anatomical factors, genetic influence, the mechanics applied, and individual susceptibility. Orthodontists understand these risks that vigorous forces and extended treatment are the main culprits for an increase in root resorption. According to a few studies, bisphosphonates and anti-inflammatories could avert the root resorption intensity at some level. However, these drugs are known to cause slower tooth movement rates.[5],[6],[7],[8],[9] Hence, in light of the above-mentioned data, the current study was undertaken to evaluate the rate of resorption of the root in endodontically treated teeth following fixed orthodontic treatment.

One hundred patients were enrolled in the present study. The mean age was 15.4 years. Out of 100 patients, root resorption was present in 30 patients. Among these 30 patients, 20 were male, whereas 10 were female. Steadman observed that endodontically treated teeth are recognized as a foreign body, and due to chronic irritation, foreign-body type reactions is seen therefore they are more susceptible to resorption. Wickwire et al. in their study concluded that devital teeth have an increased frequency of root resorption than vital teeth, but they studied the teeth that were endodontically treated after trauma, which as stated by Mah et al. are more susceptible to resorption. Furthermore, an critical aspect in analyzing the rate of root resorption.[8],[9],[10],[11]

In the current study, in 19 patients, root resorption was present in the maxillary arch, whereas in 11 patients, it was seen in the mandibular arch. The most common tooth involved with root resorption was premolars, followed by anteriors and molars. For an endodontic treatment to be called successful, the treated tooth should be able to act as an abutment for fixed and removable partial denture as well as it should be strong enough to tolerate the orthodontic forces along with the physiologic masticatory forces. Orthodontists should be mindful that endodontically treated teeth may be subjected to different types of forces in addition to the normal masticatory force. An inflammation within the tissues is caused by force functional or parafunctional forces which when overloads may lead to root resorption. Mostly, the teeth undergoing fixed orthodontic treatment are prone to root resorption. Many studies have linked apical root resorption to fixed orthodontic treatment as only 10% of teeth involved in the orthodontic movement are not at risk for apical root resorption. Resorption of almost one-third of the root's actual length may occur in <5% of the involved teeth in cases of orthodontically induced external root resorption. Among the orthodontic-related factors that can affect the orthodontic-induced external root resorption are magnitude, duration, and orthodontic force vector. In cases where orthodontically induced external root resorption is detected in the first 6 months of the active fixed orthodontic treatment, it is expected that those teeth shall probably undergo more resorption later during the treatment.[12],[13],[14]


   Conclusion Top


In view of the results of the current study, the authors concluded that endodontically treated teeth are susceptible to root resorption under orthodontic force influence.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Brezniak N, Wasserstein A. Root resorption after orthodontic treatment: Part 1. Literature review. Am J Orthod Dentofacial Orthop 1993;103:62-6.  Back to cited text no. 1
    
2.
Kjaer I. Morphological characteristics of dentitions developing excessive root resorption during orthodontic treatment. Eur J Orthod 1995;17:25-34.  Back to cited text no. 2
    
3.
Remington DN, Joondeph DR, Artun J, Riedel RA, Chapko MK. Long-term evaluation of root resorption occurring during orthodontic treatment. Am J Orthod Dentofacial Orthop 1989;96:43-6.  Back to cited text no. 3
    
4.
Bender IB, Byers MR, Mori K. Periapical replacement resorption of permanent, vital, endodontically treated incisors after orthodontic movement: Report of two cases. J Endod 1997;23:768-73.  Back to cited text no. 4
    
5.
de Souza RS, Gandini LG Jr, de Souza V, Holland R, Dezan E Jr., Influence of orthodontic dental movement on the healing process of teeth with periapical lesions. J Endod 2006;32:115-9.  Back to cited text no. 5
    
6.
Segal GR, Schiffman PH, Tuncay OC. Meta analysis of the treatment-related factors of external apical root resorption. Orthod Craniofac Res 2004;7:71-8.  Back to cited text no. 6
    
7.
Spurrier SW, Hall SH, Joondeph DR, Shapiro PA, Riedel RA. A comparison of apical root resorption during orthodontic treatment in endodontically treated and vital teeth. Am J Orthod Dentofacial Orthop 1990;97:130-4.  Back to cited text no. 7
    
8.
Wickwire NA, Mc Neil MH, Norton LA, Duell RC. The effects of tooth movement upon endodontically treated teeth. Angle Orthod 1974;44:235-42.  Back to cited text no. 8
    
9.
Steadman R. Résumé of the literature on root resorption. Angle Orthodont 1942;12:28-38.  Back to cited text no. 9
    
10.
Mattison GD, Delivanis HP, Delivanis PD, Johns PI. Orthodontic root resorption of vital and endodontically treated teeth. J Endod 1984;10:354-8.  Back to cited text no. 10
    
11.
Mah R, Holland GR, Pehovich E. Periapical changes after orthodontic movement of root-filed ferret canines. J Endod 1996;22:298-303.  Back to cited text no. 11
    
12.
Reitan K. Initial tissue behavior during apical root resorption. Angle Orthod 1974;44:68-82.  Back to cited text no. 12
    
13.
Topkara A, Karaman AI, Kau CH. Apical root resorption caused by orthodontic forces: A brief review and a long-term observation. Eur J Dent 2012;6:445-53.  Back to cited text no. 13
    
14.
Artun J, Smale I, Behbehani F, Doppel D, Van't Hof M, Kuijpers-Jagtman AM. Apical root resorption six and 12 months after initiation of fixed orthodontic appliance therapy. Angle Orthod 2005;75:919-26.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2]



 

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