DOI QR코드

DOI QR Code

External apical root resorption 6 months after initiation of orthodontic treatment: A randomized clinical trial comparing fixed appliances and orthodontic aligners

  • Received : 2020.10.08
  • Accepted : 2021.03.26
  • Published : 2021.09.25

Abstract

Objective: To compare the magnitude of external apical root resorption (EARR) 6 months after starting orthodontic treatment using orthodontic aligners (OAs) and fixed appliances (FAs). Methods: This parallel randomized clinical trial included 40 patients randomized into two groups: OA group (n = 20, 160 incisors) and FA group (n = 20, 160 incisors). For evaluation of the tooth length, periapical radiographs and standardized linear measurements of the maxillary and mandibular incisors were acquired before (T0) and 6 months after treatment initiation (T1). EARR was calculated through the difference in length between the two time points (T1-T0). Statistical comparisons were performed by means of using t-tests, chi-squared test and covariance analysis (a = 5%). Results: Rounding of the root apex was observed in both groups; the resorption involved 2.88% of the root length, so 97.12% of the tooth length remained intact. Intragroup comparisons between the two time points revealed a significant difference, with (T1-T0) ranging from -0.52 to -0.88 mm in the FA group and from -0.52 to -0.85 mm in the OA group. In the intergroup comparisons, only tooth #21 presented a statistically significant difference (OA: -0.52 ± 0.57 mm, FA: -0.86 ± 0.60 mm); however, the overall differences between groups were not clinically relevant, ranging from 0.03 to 0.35 mm. Conclusions: OA and FA treatment resulted in a similar degree of EARR in the maxillary and mandibular incisors at 6 months after treatment initiation. However, the amount of resorption was small and does not impair tooth longevity.

Keywords

References

  1. Brezniak N, Wasserstein A. Orthodontically induced inflammatory root resorption. Part I: the basic science aspects. Angle Orthod 2002;72:175-9.
  2. 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.
  3. Artun J, Van 't Hullenaar R, Doppel D, Kuijpers-Jagtman AM. Identification of orthodontic patients at risk of severe apical root resorption. Am J Orthod Dentofacial Orthop 2009;135:448-55. https://doi.org/10.1016/j.ajodo.2007.06.012
  4. Sameshima GT, Sinclair PM. Predicting and preventing root resorption. Part I: diagnostic factors. Am J Orthod Dentofacial Orthop 2001;119:505-10. https://doi.org/10.1067/mod.2001.113409
  5. Smale I, Artun J, Behbehani F, Doppel D, van't Hof M, Kuijpers-Jagtman AM. Apical root resorption 6 months after initiation of fixed orthodontic appliance therapy. Am J Orthod Dentofacial Orthop 2005;128:57-67. https://doi.org/10.1016/j.ajodo.2003.12.030
  6. Iglesias-Linares A, Sonnenberg B, Solano B, Yanez-Vico RM, Solano E, Lindauer SJ, et al. Orthodontically induced external apical root resorption in patients treated with fixed appliances vs removable aligners. Angle Orthod 2017;87:3-10. https://doi.org/10.2319/02016-101.1
  7. Yi J, Xiao J, Li Y, Li X, Zhao Z. External apical root resorption in non-extraction cases after clear aligner therapy or fixed orthodontic treatment. J Dent Sci 2018;13:48-53. https://doi.org/10.1016/j.jds.2017.09.007
  8. Azaripour A, Weusmann J, Mahmoodi B, Peppas D, Gerhold-Ay A, Van Noorden CJ, et al. Braces versus Invisalign®: gingival parameters and patients' satisfaction during treatment: a cross-sectional study. BMC Oral Health 2015;15:69. https://doi.org/10.1186/s12903-015-0060-4
  9. Currell SD, Liaw A, Blackmore Grant PD, Esterman A, Nimmo A. Orthodontic mechanotherapies and their influence on external root resorption: a systematic review. Am J Orthod Dentofacial Orthop 2019; 155:313-29. https://doi.org/10.1016/j.ajodo.2018.10.015
  10. Eissa O, Carlyle T, El-Bialy T. Evaluation of root length following treatment with clear aligners and two different fixed orthodontic appliances. A pilot study J Orthod Sci 2018;7:11.
  11. Barbagallo LJ, Jones AS, Petocz P, Darendeliler MA. Physical properties of root cementum: part 10. Comparison of the effects of invisible removable thermoplastic appliances with light and heavy orthodontic forces on premolar cementum. A microcomputed-tomography study. Am J Orthod Dentofacial Orthop 2008;133:218-27. https://doi.org/10.1016/j.ajodo.2006.01.043
  12. Nassif CE, Cotrim-Ferreira A, Conti ACCF, Valarelli DP, de Almeida Cardoso M, de Almeida-Pedrin RR. Comparative study of root resorption of maxillary incisors in patients treated with lingual and buccal orthodontics. Angle Orthod 2017;87:795-800. https://doi.org/10.2319/041117-247.1
  13. Pandis N. Randomization. Part 1: sequence generation. Am J Orthod Dentofacial Orthop 2011;140: 747-8. https://doi.org/10.1016/j.ajodo.2011.06.020
  14. Fleiss JL. Confidence intervals vs significance tests: quantitative interpretation. Am J Public Health 1986;76:587-8. https://doi.org/10.2105/AJPH.76.5.587
  15. Lund H, Grondahl K, Hansen K, Grondahl HG. Apical root resorption during orthodontic treatment. A prospective study using cone beam CT. Angle Orthod 2012;82:480-7. https://doi.org/10.2319/061311-390.1
  16. Krieger E, Drechsler T, Schmidtmann I, Jacobs C, Haag S, Wehrbein H. Apical root resorption during orthodontic treatment with aligners? A retrospective radiometric study. Head Face Med 2013;9:21. https://doi.org/10.1186/1746-160X-9-21
  17. Gay G, Ravera S, Castroflorio T, Garino F, Rossini G, Parrini S, et al. Root resorption during orthodontic treatment with Invisalign®: a radiometric study. Prog Orthod 2017;18:12. https://doi.org/10.1186/s40510-017-0166-0
  18. Li Y, Deng S, Mei L, Li Z, Zhang X, Yang C, et al. Prevalence and severity of apical root resorption during orthodontic treatment with clear aligners and fixed appliances: a cone beam computed tomography study. Prog Orthod 2020;21:1. https://doi.org/10.1186/s40510-019-0301-1
  19. Altman DG. Randomisation. BMJ 1991;302:1481-2. https://doi.org/10.1136/bmj.302.6791.1481
  20. Leite V, Conti AC, Navarro R, Almeida M, Oltramari-Navarro P, Almeida R. Comparison of root resorption between self-ligating and conventional preadjusted brackets using cone beam computed tomography. Angle Orthod 2012;82:1078-82. https://doi.org/10.2319/080911-501.1
  21. Levander E, Malmgren O, Eliasson S. Evaluation of root resorption in relation to two orthodontic treatment regimes. A clinical experimental study. Eur J Orthod 1994;16:223-8. https://doi.org/10.1093/ejo/16.3.223
  22. Apajalahti S, Peltola JS. Apical root resorption after orthodontic treatment -- a retrospective study. Eur J Orthod 2007;29:408-12. https://doi.org/10.1093/ejo/cjm016
  23. Reitan K. Initial tissue behavior during apical root resorption. Angle Orthod 1974;44:68-82.