Title

Root Resorption Associated With Orthodontic Tooth Movement

Clinical Question

In patients undergoing orthodontic treatment, what factors affect external apical root resorption?

Clinical Bottom Line

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. (See Comments on the CAT below)

Best Evidence

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
20362905	Weltman/2010	Comprehensive Orthodontic Patients with root resoption	Systematic Review
Key results	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 arch-wire 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.

Evidence Search

("root resorption"[MeSH Terms] OR ("root"[All Fields] AND "resorption"[All Fields]) OR "root resorption"[All Fields]) AND ("Orthod Rev"[Journal] OR "Orthod Epitheorese"[Journal] OR ("orthodontic"[All Fields] AND "review"[All Fields]) OR "orthodontic review"[All Fields])

Comments on
The Evidence

Blinding for outcome evaluation was reported in 5 trials. The reporting and analysis of withdrawals and dropouts was considered adequate in all 11 trials. Five studies were assessed to have low risk of bias, 5 had moderate risk of bias, and 1 had the potential for a high risk of bias.

Applicability

Increased incidence and severity of OIIRR is found in patients undergoing comprehensive orthodontictherapy. Heavy force application produced signiﬁcantly more OIIRR than light force application or control. Other trends from split-mouth studies could not be substantiated because of few subjects and short treatment times. Standard reporting methods of future clinical trials are recommended so that data can be pooled quantitatively and stronger clinical recommendations made.

Specialty

(Orthodontics)

Keywords

Orthodontics, Root Resorption.

ID#

2297

Date of submission

05/22/2012

E-mail

leejs@livemail.uthscsa.edu

Author

Josh Lee

Co-author(s)

Co-author(s) e-mail

Faculty mentor

Clarence C. Bryk, DDS, MS

Faculty mentor e-mail

bryk@uthscsa.edu

Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

by Camaron Martin (Fair Oaks Ranch, TX) on 07/11/2012
This CAT still asks a relevant question, and the systematic review cited is still the most current and relevant information. More research on the subject, with quantative and qualitative measures, is needed for a stronger evidence based answer.