ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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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 (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20362905 Weltman/2010Comprehensive Orthodontic Patients with root resoptionSystematic Review
Key resultsThe 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 signi´Čücantly 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/Discipline (Orthodontics)
Keywords Orthodontics, Root Resorption.
ID# 2297
Date of submission: 05/22/2012spacer
E-mail leejs@livemail.uthscsa.edu
Author Josh Lee
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Clarence C. Bryk, DDS, MS
Faculty mentor/Co-author 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?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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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.
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