The clinical management of orthodontically-induced external root resorption: a questionnaire survey
Date
2021
Authors
Currell, S.D.
Blackmore Grant, P.D.
Esterman, A.
Nimmo, A.
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Journal article
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American Journal of Orthodontics and Dentofacial Orthopedics, 2021; 160(3):385-391
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Abstract
Introduction: With more dentists performing orthodontics, identifying and managing patients at risk or affected by orthodontically-induced external root resorption (OIERR) is paramount.
Methods: This study, conducted according to STROBE (STrengthening the Reporting of OBservational studies in Epidemiology), studied Australian orthodontists. Orthodontists were asked to complete a clinical questionnaire evaluating their diagnostic and management approaches to OIERR.
Results: Orthodontists most commonly use a history of previous root resorption and the use of an orthopantomogram to screen and monitor patients. An orthopantomogram is used either 6 months for those identified as at risk of OIERR or 10-12 months for those who are not. Once detected, most orthodontists will record OIERR in terms of severity. If severe root resorption was detected, orthodontists would compromise on the treatment outcome and promptly complete treatment; if extraction sites remain closed, most orthodontists will interrupt treatment for 3-6 months. After treatment, orthodontists’ retention protocol is unchanged regardless of OIERR experience. Treatment planning for patients with generalized OIERR before treatment (P = 0.002) was the only decision shown to be associated with years of clinical experience (P >0.05).
Conclusions: It is shown that no 1 method for managing OIERR exists, with most orthodontists arguing patient specificity to treatment modality. The various selected clinical approaches accurately reflect the current state of scientific literature on the topic.Orthodontic appliances work by placing force on a tooth in a prescribed direction. This force results in either tension or compression of the periodontal ligament, resulting in trauma followed by the release of inflammatory mediators.1 Although the inflammatory response leads to tooth movement, it can also cause orthodontically-induced external root resorption (OIERR). Forces applied to the periodontal ligament can lead to load-induced sterile necrosis.2,3 resulting in irreversible resorption of superficial root cementum and, in more severe patients, the underlying dentin.4, 5, 6
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Copyright 2021 Elsevier