ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Risk of Severe Apical Root Resorption During Active Phase of Orthodontic Treatment Can be Predicted
Clinical Question In patients undergoing orthodontic treatment, can severe root resorption, compared to clinically insignificant resorption, be predicted in early treatment phases?
Clinical Bottom Line Patients at risk of severe apical root resorption in the active phase can be identified according to the amount of resorption during the initial treatment stages.
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) 19361730 Artun/2009n=267Prospective cohort
Key resultsThrough measuring the amount of apical root resorption at four phases of treatment (before treatment, 6 months and 12 months after placing brackets, and active treatment), it was determined that the severity of resorption at the end of active treatment could be predicted. Severe resorption was defined as 5mm or greater of apical root resorption in at least one incisor at the end of active treatment. Spearman R values for amount of resorption at T2 vs T4 ranged from 0.61 to 0.76 for each incisor; were 0.65,0.77, and 0.74 for average resorption of the measured central incisor, the measured lateral incisor, and all measured incisors, respectively; and was 0.73 for the most severely resorbed incisor per patient (P.001). Similar coefficients at T3 vs T4 ranged from 0.77 to 0.88 for each incisor; were 0.80, 0.86, and 0.86 for average resorption of the measured central incisor, the measured lateral incisor, and all measured incisors, respectively; and was 0.85 for the most severely resorbed central teeth per patient (P.001). Exclusively extraction therapy and amount of resorption at T3 were regarded in the final model as risk factors It was determined that the risk was 3 times higher in patients with at least one incisor with 1mm of resorption and 15 times higher in patients with 2mm or more of resorption at 6 mos. The risk was 6 times higher in patients with 2mm of resorption and 20 times higher in patients with at least 3mm of resorption at 12 months.
Evidence Search The following search strategy used in PubMed: MeSH Terms Odontometry Orthodontics Prospective, Studies Radiography, Dental, Digital Risk Assessment
Comments on
The Evidence
The study design corrected for errors resulting from the distortion or magnification of radiographs, making measurements more accurate and reproducible. The diagnostic radiograph protocol is comprehensive and consistently applied on a large number of patients. More studies, preferably in a randomized control design, need to be performed to confirm the findings of the current study. The protocol is comprehensive and consistently applied on a large number of patients.
Applicability Taking two radiographs routinely after 6 and 12 months of starting the treatment enables us to predict the incidence of severe external root resorption after entering the active phase. This should be used to determine appropriate treatment of patients prone to apical root resorption. Cause and prevention of the resorptive process need to be determined.
Specialty/Discipline (Endodontics) (General Dentistry) (Orthodontics) (Pediatric Dentistry)
Keywords External root resorption, orthodontic, active phase, central resorption
ID# 2705
Date of submission: 03/14/2014spacer
E-mail hooman.abdolisereshki@ucdenver.edu
Author Hooman Abdolisereshki
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ethelyn Thomason, DMD
Faculty mentor/Co-author e-mail ethelyn.thomasonlarsen@ucdenver.edu
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