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Moga RA, Olteanu CD, Delean AG. Trabecular Bone Component Assessment under Orthodontic Loads and Movements during Periodontal Breakdown-A Finite Elements Analysis. Dent J (Basel) 2024; 12:190. [PMID: 38920891 PMCID: PMC11202809 DOI: 10.3390/dj12060190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
This numerical analysis, by employing Tresca and Von Mises failure criteria, assessed the biomechanical behavior of a trabecular bone component subjected to 0.6, 1.2, and 2.4 N orthodontic forces under five movements (intrusion, extrusion, tipping, rotation, and translation) and during a gradual horizontal periodontal breakdown (0-8 mm). Additionally, they assessed the changes produced by bone loss, and the ischemic and resorptive risks. The analysis employed eighty-one models of nine patients in 405 simulations. Both failure criteria showed similar qualitative results, with Tresca being quantitatively higher by 1.09-1.21. No qualitative differences were seen between the three orthodontic loads. Quantitatively, a doubling (1.2 N) and quadrupling (2.4 N) were visible when compared to 0.6 N. Rotation and translation followed by tipping are the most stressful, especially for a reduced periodontium, prone to higher ischemic and resorptive risks. In an intact periodontium, 1.2 N can be safely applied but only in a reduced periodontium for extrusion and intrusion. More than 0.6 N is prone to increasing ischemic and resorptive risks for the other three movements. In an intact periodontium, stress spreads in the entire trabecular structure. In a reduced periodontium, stress concentrates (after a 4 mm loss-marker for the stress change distribution) and increases around the cervical third of the remaining alveolar socket.
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Affiliation(s)
- Radu-Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Strada Motilor 33, 400001 Cluj-Napoca, Romania;
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Strada Avram Iancu 31, 400083 Cluj-Napoca, Romania
| | - Ada Gabriela Delean
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Strada Motilor 33, 400001 Cluj-Napoca, Romania;
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Shalish M, Abed J, Keinan D, Slutzky-Goldberg I. The consequences of orthodontic extrusion on previously intruded permanent incisors-A retrospective study. Dent Traumatol 2024; 40:54-60. [PMID: 37638617 DOI: 10.1111/edt.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/29/2023]
Abstract
AIM The aim of this study is to compare the adverse effects that occur after orthodontic extrusion of teeth that have been traumatically intruded with those of similar teeth that have not experienced any trauma. BACKGROUND The outcome of incisors intrusion can be affected by the patient's age, extent of injury, root development, and malocclusion. Orthodontic extrusion is a potential solution, but it may also cause complications. MATERIALS AND METHODS A retrospective study of the effects of extrusion of traumatically intruded teeth was carried out. The study group included 21 teeth in 14 patients. The control group included 32 teeth in 10 patients that underwent orthodontic extrusion with no history of trauma. Patients' age, gender, and stage of root development were recorded. The severity of the intrusion was classified as mild (<3 mm), moderate (3-6 mm), and severe (≥7 mm). A comparison of signs of pulp necrosis and root resorptions between the groups was made. RESULTS The central incisor is the tooth that is most injured in 80.9% of cases. A majority of these incidents involve severe intrusion, which was found in 42.9% of cases. 90% of the traumatized teeth had already lost their vitality prior to orthodontic treatment. Various forms of root resorption were observed in the study group. In the control group, 31.2% of teeth showed signs of external root resorption, but no endodontic intervention was carried out during the follow-up period, as these teeth remained vital. CONCLUSIONS Following intrusion, there is a high risk for root resorption and pulp necrosis. Orthodontic repositioning should be carried out with caution and mild force to prevent complications. Long-term follow-ups are required to ensure the best possible outcome.
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Affiliation(s)
- Miriam Shalish
- Department of Orthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jawad Abed
- Department of Oral and Maxillofacial Surgery, Orthodontic Division, Baruch Padeh Medical Center Poriya, The Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel
| | - David Keinan
- Department of Endodontology, The Maurice and Gabriella Golschlegger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Iris Slutzky-Goldberg
- Department of Endodontics, Galilee College of Dental Sciences, The Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel
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Dawood HM, Kroeger A, Chavda V, Chapple ILC, Kebschull M. Under pressure-mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review. Eur J Orthod 2023; 45:612-626. [PMID: 37366151 PMCID: PMC10505745 DOI: 10.1093/ejo/cjad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
BACKGROUND The application of orthodontic forces causes root resorption of variable severity with potentially severe clinical ramifications. OBJECTIVE To systematically review reports on the pathophysiological mechanisms of orthodontically induced inflammatory root resorption (OIIRR) and the associated risk factors based on in vitro, experimental, and in vivo studies. SEARCH METHODS We undertook an electronic search of four databases and a separate hand-search. SELECTION CRITERIA Studies reporting on the effect of orthodontic forces with/without the addition of potential risk factors on OIIRR, including (1) gene expression in in-vitro studies, the incidence root resorption in (2) animal studies, and (3) human studies. DATA COLLECTION AND ANALYSIS Potential hits underwent a two-step selection, data extraction, quality assessment, and systematic appraisal performed by duplicate examiners. RESULTS One hundred and eighteen articles met the eligibility criteria. Studies varied considerably in methodology, reporting of results, and variable risk of bias judgements.In summary, the variable evidence identified supports the notion that the application of orthodontic forces leads to (1) characteristic alterations of molecular expression profiles in vitro, (2) an increased rate of OIIRR in animal models, as well as (3) in human studies. Importantly, the additional presence of risk factors such as malocclusion, previous trauma, and medications like corticosteroids increased the severity of OIIRR, whilst other factors decreased its severity, including oral contraceptives, baicalin, and high caffeine. CONCLUSIONS Based on the systematically reviewed evidence, OIIRR seems to be an inevitable consequence of the application of orthodontic forces-with different risk factors modifying its severity. Our review has identified several molecular mechanisms that can help explain this link between orthodontic forces and OIIRR. Nevertheless, it must be noted that the available eligible literature was in part significantly confounded by bias and was characterized by substantial methodological heterogeneity, suggesting that the results of this systematic review should be interpreted with caution. REGISTRATION PROSPERO (CRD42021243431).
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Affiliation(s)
- Hassan M Dawood
- Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
| | - Annika Kroeger
- Department of Oral Surgery, School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Vinay Chavda
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Iain L C Chapple
- Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Moritz Kebschull
- Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
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Parashos P. Endodontic-orthodontic interactions: a review and treatment recommendations. Aust Dent J 2023; 68 Suppl 1:S66-S81. [PMID: 37961018 DOI: 10.1111/adj.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 11/15/2023]
Abstract
The literature is replete with articles describing the many and varied interactions between endodontic treatment and orthodontic tooth movement (OTM), often reporting conflicting views and findings, which creates confusion for clinicians. Original research and review articles have described aspects such as apical root resorption and potential pulpal complications of teeth related to OTM. Some interactions are of relatively minor clinical significance, whilst others may have adverse consequences. A history of dental trauma before or during OTM further complicates the interactions. This review re-assesses the historical literature on endodontic-orthodontic interactions in light of more recent research and presents guidelines for managing clinical situations involving both disciplines. © 2023 Australian Dental Association.
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Affiliation(s)
- P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Mohammed-Salih HS, Al-lami HA, Saloom HF, Abdulkareem AA, Al-Obaidi JR, Razali N. Detection of orthodontically induced inflammatory root resorption-associated biomarkers from the gingival crevicular fluid by proteomics analysis: a randomized-controlled clinical trial. 3 Biotech 2023; 13:157. [PMID: 37151999 PMCID: PMC10154447 DOI: 10.1007/s13205-023-03572-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 04/19/2023] [Indexed: 05/09/2023] Open
Abstract
Orthodontically induced inflammatory root resorption (OIIRR) is an undesirable complication of orthodontic treatment (OT) with an ambiguous aetiologic mechanism. This study aimed to identify OIIRR-associated biomarkers in the gingival crevicular fluid (GCF) using proteomic analysis. In this randomized clinical trial, the upper first premolars (UFP) were exposed either to light or heavy force. The GCF was collected at 1 h, 1 day, 7 days, 14 days, 21 days, and 28 days following force application. After extraction of UFP, roots were imaged and resorption premolar, was used to deliver either light forcecraters were measured. Proteomic analysis of GCF was performed using 2D gel electrophoresis with MALDI-TOF/TOF MS/MS. Results were further analyzed by bioinformatics analyses showing the biological functions and predicted pathways. The predicted canonical pathways showed that the expression of immunoglobulin kappa (IGKC), neutrophil gelatinase-associated lipocalin (NGAL), neurolysin mitochondrial (NEUL), keratin, type II cytoskeletal 1 (K2C1), S100-A9, and the extracellular calcium-sensing receptor (CASR) were significantly associated with a range of biological and inflammatory processes. In conclusion, up-regulation of S100A9, CASR, and K2C1 suggested a response to force-related inflammation, chemotactic activities, osteoclastogenesis, and epithelial cell breakdown. Meanwhile, the up-regulation of IGKC, NGAL, and K2C1 indicated a response to the inflammatory process, innate immunity activation, and epithelial cell breakdown. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-023-03572-5.
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Affiliation(s)
| | - Hadeel Adel Al-lami
- Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, 10011 Iraq
| | - Hayder F. Saloom
- Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, 10011 Iraq
| | - Ali Abbas Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, 10011 Iraq
| | - Jameel R. Al-Obaidi
- Department of Biology, Faculty of Science and Mathematics, Universiti Pendidikan Sultan Idris, 35900 Tanjong Malim, Perak Malaysia
| | - Nurhanani Razali
- Membranology Unit, Okinawa Institute of Science and Technology Graduate University, 1919-1, Tancha, Onna-son, Kunigami-kun, Okinawa, 904-0495 Japan
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Zhao D, Xue K, Meng J, Hu M, Bi F, Tan X. Orthodontically induced external apical root resorption considerations of root-filled teeth vs vital pulp teeth: a systematic review and meta-analysis. BMC Oral Health 2023; 23:241. [PMID: 37098519 PMCID: PMC10131310 DOI: 10.1186/s12903-023-02982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/20/2023] [Indexed: 04/27/2023] Open
Abstract
INTRODUCTION The purpose of this systematic review was to research the difference between root-filled teeth (RFT) and vital pulp teeth (VPT) in orthodontically induced external apical root resorption (EARR) and to offer suggestions for clinicians on therapeutic sequence and timing when considering combined treatment of endodontic and orthodontic. MATERIALS AND METHODS An electronic search of published studies was conducted before November 2022 in PubMed, Web of Science and other databases. Eligibility criteria were based on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) framework. RevMan 5.3 software was used for statistical analysis. Single-factor meta-regression analysis was used to explore the sources of literature heterogeneity, and a random effects model was used for analysis. RESULTS This meta-analysis comprised 8 studies with 10 sets of data. As there was significant heterogeneity among the studies, we employed a random effects model. The funnel plot of the random effects model exhibited a symmetrical distribution, indicating no publication bias among the included studies. The EARR rate of RFT was significantly lower than that of VPT. CONCLUSIONS In the context of concurrent endodontic and orthodontic treatment, priority should be given to endodontic therapy, as it serves as the foundation for subsequent orthodontic procedures. The optimal timing for orthodontic tooth movement post-root canal therapy is contingent upon factors such as the extent of periapical lesion resolution and the degree of dental trauma sustained. A comprehensive clinical assessment is essential in guiding the selection of the most suitable approach for achieving optimal treatment outcomes.
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Affiliation(s)
- Danning Zhao
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Kun Xue
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Jiayuan Meng
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Meijing Hu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fei Bi
- Department of Orthodontics, State Key Laboratory of Oral Diseases, National Clinical Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Xuelian Tan
- Department of Cariology and Endodontics, State Key Laboratory of Oral Diseases, National Clinical Center for Oral Diseases, West China School of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China.
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Parrales-Bravo C, Friedrichsdorf SP, Costa C, Paiva JB, Iglesias-Linares A. Does endodontics influence radiological detection of external root resorption? an in vitro study. BMC Oral Health 2023; 23:221. [PMID: 37069535 PMCID: PMC10108466 DOI: 10.1186/s12903-023-02871-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/10/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND External root resorption (ERR) has a multifactorial etiology and is difficult to diagnose, which means that is continues to be of research interest. This work mainly aims to determine whether external root resorption can be differentially detected in root-filled versus non-endodontically treated teeth using digital periapical radiography (DPR) and cone-beam computed tomography (CBCT). METHODS The Checklist for Reporting In-vitro Studies (CRIS) guidelines were followed throughout this study. This experiment highlights the preparation and generation of standardized synthetic teeth measured on three-dimensional records converted into Digital Imaging and Communication on Medicine (DICOM) file format. Twelve replicate maxillary incisors were randomized into two groups: (G1) six non-endodontically treated, and (G2) six endodontically treated teeth. In both groups, actual tooth lengths of all specimens were measured and compared with measurements obtained using DPR and CBCT. Simulated ERR lesions [0.12, 0.18, 0.20 mm × 0.5 mm depth in the mesial, distal and palatal apical regions] were created progressively, radiographic images were recorded, and 24 DPRs and 96 CBCTs were obtained in total. Eight blinded, previously calibrated researchers made a total of 1920 measurements (using Horos Software). Data were analyzed using the Shapiro-Wilk, ANOVA, Kruskal-Wallis and Wilcoxon rank post-hoc tests [Bonferroni correction in multiple comparison tests (p < 0.05)]. RESULTS ICC values for intra- and inter-examiner agreement were appropriate. DPR overestimated ERR detection compared to the actual and CBCT measurements [Mean diff = 0.765 and 0.768, respectively]. CBCT diagnosis of ERR lesions in specimens without root canal treatment was significantly more accurate than DPR diagnoses on both non-endodontically and endodontically-treated specimens [p = 0.044; p = 0.037, respectively]. There was an 18.5% reduction in sensitivity in all DPR diagnoses made on endodontic teeth versus those made on non-endodontically treated teeth. For the smallest ERR lesions, this sensitivity was even more marked, with 27.8 and 25% less sensitivity, respectively. CONCLUSIONS The results of this study highlight that both CBCT and DPR are good diagnostic methods for ERR. Nevertheless, root canal filling material influences diagnostic capability in ERR. The clinical significance was that the presence of intracanal material reduces the detection and diagnosis of ERR by DPR in teeth with root canal treatment.
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Affiliation(s)
- C. Parrales-Bravo
- School of Dentistry, University of Guayaquil, Guayaquil, Ecuador
- School of Dentistry, Complutense, BIOCRAN Research Group, Complutense University of Madrid, Madrid, Spain
| | | | - C. Costa
- School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - J. B. Paiva
- School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - A. Iglesias-Linares
- School of Dentistry, Complutense, BIOCRAN Research Group, Complutense University of Madrid, Madrid, Spain
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Su R, Li S, Zhang C, Hou J. Effective endodontically treated incisors with external root resorption during orthodontic movement: A case report. Clin Case Rep 2023; 11:e7073. [PMID: 36992676 PMCID: PMC10041545 DOI: 10.1002/ccr3.7073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/26/2022] [Accepted: 01/03/2023] [Indexed: 03/29/2023] Open
Abstract
This case report describes a 21-year-old orthodontic patient experienced the external apical root resorption of maxillary central incisors with pulpitis during the orthodontic movement. The active cooperation of orthodontists and endodontists demonstrated the satisfactory treatment outcome and prevented further apical root resorption. The etiology of external apical root resorption is comprehensive, orthodontists should be armed with an adequate training and scientific knowledge, and keep the treatment mechanism simple and precise to guard against it. Besides, we should know the right timing of endodontic treatment and applying orthodontic force when external apical root resorption occurs.
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Affiliation(s)
- Rugan Su
- Department of Orthodontics, School of Stomatology Capital Medical University Beijing China
| | - Song Li
- Department of Orthodontics, School of Stomatology Capital Medical University Beijing China
| | - Chen Zhang
- Department of Endodontics, School of Stomatology Capital Medical University Beijing China
| | - Jingyi Hou
- Department of Orthodontics, School of Stomatology Capital Medical University Beijing China
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Lee YJ, Pak H, Hwang CJ, Choi YJ, Lee JH, Lee JH, Cha JY. Targeted next-generation sequencing for comprehensive genetic analysis of external apical root resorption during orthodontic treatment with premolar extraction in the Korean population. Am J Orthod Dentofacial Orthop 2022; 162:668-679.e5. [PMID: 35965166 DOI: 10.1016/j.ajodo.2021.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION External apical root resorption (EARR) is one of the most common unfavorable consequences of orthodontic treatment and causes loss of tooth structure. The present study aimed to investigate the genetics of EARR using next-generation sequencing comprehensively. METHODS Targeted next-generation sequencing was performed for comprehensive genetic analysis of 118 Korean orthodontic patients. The patients were divided into 2 groups on the basis of their EARR value. The association of clinical and genetic parameters with EARR was assessed using the χ2 test or t test for matched pairs, followed by Bonferroni correction and linear regression analysis. In addition, haplotype analysis and in silico prediction were conducted to evaluate functional effects. RESULTS No statistically significant difference was observed between clinical and treatment-related parameters and EARR. The single nucleotide polymorphisms SPP1 rs9138 (P = 0.001) and SFRP2 rs3810765 (P = 0.04) showed only nominal significance between EARR groups. However, these 2 SNPs were not significant after Bonferroni correction for multiple testing (cutoff P = 0.05/142 = 3.52 × 10-4). Variations in SPP1 rs9138 and SFRP2 rs3810765 may be related to EARR during orthodontic treatment. In summary, not only genes related to inflammatory reactions but also those related to Wnt signaling to affect the degree of EARR during orthodontic teeth movement.
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Affiliation(s)
- Yun-Ju Lee
- Department of Orthodontics, Yonsei University College of Dentistry, Seodaemoon-gu, Seoul, South Korea
| | - Hayeon Pak
- Department of Biomedical and Pharmaceutical Sciences, Graduate School, Kyung Hee University, Dongdaemoon-gu, Seoul, South Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, Yonsei University College of Dentistry, Seodaemoon-gu, Seoul, South Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, Yonsei University College of Dentistry, Seodaemoon-gu, Seoul, South Korea
| | - Jae-Hoon Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seodaemoon-gu, Seoul, South Korea
| | - Ji Hyun Lee
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, and Department of Biomedical Science and Technology, Kyung Hee Medical Science Research Institute, and Department of Biomedical and Pharmaceutical Sciences, Kyung Hee University, Dongdaemun-gu, Seoul, South Korea.
| | - Jung-Yul Cha
- Department of Orthodontics, Yonsei University College of Dentistry, Seodaemoon-gu, Seoul, South Korea.
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Root Surface Changes in Endodontically Treated Teeth Following Orthodontic Movement. J Endod 2022; 48:1361-1366. [PMID: 35964706 DOI: 10.1016/j.joen.2022.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Orthodontically induced external root resorption (OIERR) has been labeled an unavoidable consequence of orthodontic tooth movement (OTM). The objective of this study was to investigate the change in surface area (mm2) and volume (mm3) of endodontically treated teeth (ETT) compared to contralateral teeth with a vital pulp (VPT) following OTM. METHODS Seventy-six teeth were included in this retrospective analysis: ETT (n=38) and VPT (n=38). All teeth were evaluated using CBCT imaging at two time periods: before OTM (T1) and after OTM (T2). Study teeth were segmented to include all areas contained within the lamina dura and then were converted into a mesh model for data calculation. The surface area (mm2) and volume (mm3) of each tooth was calculated at T1 and T2 based on the number of cubic voxels present within the mesh model. Statistical analysis was performed using a linear mixed-effects model. RESULTS The average change in surface area following OTM in ETT was 13.01 mm2, and 19.95 mm2 in VPT (p<0.05). The average percent change in surface area following OTM in ETT was 2.09%, and 3.38% in VPT (p<0.05). The average change in volume following OTM in ETT was 22.48 mm3, and 32.44 mm3 in VPT (p<0.05). The average percent change in volume following OTM in ETT was 2.62%, and 4.10% in VPT (p<0.05). CONCLUSIONS The results from this study suggest that ETT are less susceptible to root resorption following OTM than their vital counterparts.
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Alves Otelakoski B, Magno Gonçalves F, Marques de Mattos de Araujo B, Zeigelboim BS, Veríssimo Meira Taveira K, Sampaio Santos R, Guariza-Filho O, Stechman-Neto J, Miranda de Araujo C. Comparison of orthodontic root resorption of root-filled and vital teeth. J Am Dent Assoc 2022; 153:532-541.e7. [DOI: 10.1016/j.adaj.2021.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022]
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NEVES BMD, FERNANDES LQP, CAPELLI JUNIOR J. External apical root resorption after orthodontic treatment: analysis in different chronological periods. Dental Press J Orthod 2022; 27:e2220100. [PMID: 36350942 PMCID: PMC9639616 DOI: 10.1590/2177-6709.27.5.e2220100.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 07/14/2021] [Indexed: 11/09/2022] Open
Abstract
Introduction: External apical root resorption (EARR) is characterized by the definitive loss of tooth root structure, with a higher incidence in lateral and central maxillary incisors. Objective: To identify, in different chronological periods, the incidence of EARR in the maxillary incisors (MI) of patients orthodontically treated with or without premolars extraction. Methods: Periapical radiographs before and after orthodontic treatment of 1,304 MIs from 326 patients (205 women and 121 men) were evaluated for EARR, divided into five groups, according to the chronological period in which treatments were started: G90) from 1990 to 1994, G95) from 1995 to 1999, G00) from 2000 to 2004, G05) from 2005 to 2009, G10) from 2010 to 2015. The evaluation was performed in each group, in patients who underwent maxillary first premolars extraction and those who did not. For statistical analysis, Fisher’s exact test was used, with a significance level of p < 0.05. The EARR was measured using the adapted Levander and Malmgren classification. Results: Incidence of EARR was higher in MIs of patients treated with maxillary premolar extraction (p < 0.05) in two chronological periods (G00 and G10), also being influenced by orthodontic treatments with longer duration, and due to possible individual genetic factors. Conclusion: Even with the limitations of a retrospective study, the lack of a defined EARR pattern in the MIs at different chronological periods was larger in the experimental group, due to the sum of factors such as premolars extraction, prolonged orthodontic treatment, possible genetic characteristics, and root shape, without the influence of the sex and age.
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Sameshima GT, Iglesias-Linares A. Orthodontic root resorption. J World Fed Orthod 2021; 10:135-143. [PMID: 34785166 DOI: 10.1016/j.ejwf.2021.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022]
Abstract
External apical root resorption (EARR) is one of the most frequently reported iatrogenic side effects of orthodontic movement. Nevertheless, no robust and unequivocal scientific evidence is yet available in the literature regarding the clinical and biological factors that trigger EARR. The purpose of the present position paper is to provide clinicians, residents, and investigators a summary of our current understanding about root resorption caused by orthodontic tooth movement, based on up-to-date available scientific evidence. Morphological, structural, biomechanical, and biological differences account for predisposing the apical third to EARR compared to other root surfaces during orthodontic treatment. In addition, a relevant number of patient and treatment-related factors increase risk of EARR. The main patient-related factors are reviewed and discussed: genetic factors, tooth anatomy, demographic factors, malocclusion factors, previous endodontic treatment, medical history, short root anomaly. Similarly, the influence of treatment-related factors are analyzed with regard to the effect of: biomechanical factors, type of orthodontic appliance, adjunctive therapies to accelerate tooth movement, early treatment, maxillary expansion, teeth extractions, the duration of treatment and the amount of apical displacement. Clinical management of EARR from pre-treatment records to the monitoring strategy as well as recommendations for the post orthodontic-treatment period are presented as a guide for the clinician. Despite years of studies, we still do not fully understand EARR, but the future is promising. True three-dimensional imaging with higher resolution and low radiation, and predictive tools towards an earlier detection without radiographs, will mark future developments in the field of EARR in orthodontics.
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Affiliation(s)
- Glenn T Sameshima
- Advanced Orthodontics, Herman Ostrow School of Dentistry of University of Southern California (USC), Los Angeles, California, USA.
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An Assessment of the Effects of Orthodontic Treatment after Apexification of Traumatized Immature Permanent Teeth: A Retrospective Study. J Endod 2021; 48:96-101. [PMID: 34619170 DOI: 10.1016/j.joen.2021.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Root resorption may occur in traumatized necrotic teeth that have undergone apexification after orthodontic treatment. This study examined the effects of orthodontic treatment on the outcome of apexification. METHODS This retrospective study included 36 children presenting with anterior permanent traumatized teeth with immature roots who were treated by apexification and root canal treatment. The orthodontic group consisted of 17 children with 24 teeth that were subjected to orthodontic treatment after apexification. The control group consisted of 19 children with 21 teeth that underwent only apexification without orthodontic treatment. Almost half of the teeth in both groups underwent apexification with calcium hydroxide, whereas the other half were treated with mineral trioxide aggregate. The effects of sex, stage of root development, and apexification material on the outcomes of apexification were analyzed and compared between the 2 groups. RESULTS Apexification was successful in 88% of cases after at least 5 years of follow-up. Neither apexification technique nor sex had a significant effect on treatment outcome. The stage of root development had a positive effect on outcome, although it was not statistically significant. Some root resorption (average = 0.3 mm) was observed after orthodontic treatment, whereas teeth that underwent apexification without orthodontic treatment exhibited some root elongation (average = 0.1 mm). This difference was highly significant. CONCLUSIONS Minor root resorption was observed in the orthodontic group compared with a minor increase in root length in the control group. Orthodontic movement of immature traumatized teeth after apexification appears to be safe.
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15
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The Radiological Assessment of Root Features and Periodontal Structures in Endodontically Treated Teeth Subjected to Forces Generated by Fixed Orthodontic Appliances. A Prospective, Clinical Cohort Study. J Clin Med 2021; 10:jcm10102078. [PMID: 34066264 PMCID: PMC8152016 DOI: 10.3390/jcm10102078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 11/24/2022] Open
Abstract
The various side effects of orthodontic treatment with fixed orthodontic appliances (FOAs) and their impact on apical and periodontal structures have been widely reported. However, the existing data is not yet conclusive. Aims and objectives: To investigate the status of roots and periodontium in endodontically treated teeth that have undergone orthodontic treatment with the use of FOAs and to evaluate their impact on apical/periodontal structures. Material and methods: The prospective clinical cohort study initially involved 69 participants aged 16–40, without underlying systemic conditions, who received orthodontic treatment with ligatureless FOA systems due to different types of mild and moderate malocclusions. To meet the required criteria, 88 teeth in 34 patients were assessed clinically and radiologically. Participants had at least one tooth treated endodontically while the corresponding tooth from the same anatomical group on the opposite side was vital and intact (a ‘split-mouth’ approach). Four cohorts were allocated: Group IA consisted of 15 teeth, treated utilising the principles of modern endodontics, that were subjected to orthodontic forces no less than six months after completing the root canal obturation. Group I consisted of 13 similarly endodontically treated teeth, which commenced orthodontic treatment at least six months after the completed endodontic therapy. Group II contained 16 teeth treated by conventional endodontic methods and the control group, Group III, contained 44 clinically and radiologically intact teeth (incisors and premolars) with vital and sound dental pulp. The response of apical and periodontal structures to FOAs was determined by data collected from intraoral periapical radiographs taken within the course of five consecutive appointments during the orthodontic treatment. Results: No statistically significant differences were observed in susceptibility to FOA-induced external apical root resorption (EARR) between combined Groups IA + IB and II. An association was, however, demonstrated, between the occurrence of EARR and the degree of expansion of the periodontal ligament (PDL) space, regardless the method of root canal treatment. Cumulative data revealed a positive correlation between the width of the PDL space and the stage of FOA treatment (the third and the fourth appointment). The subtle changes in radiological length of roots have been observed (min 0 mm/max 0.38 mm), particularly between the second and third appointment in Group II (p < 0.05). Conclusions: The standard orthodontic therapy with FOAs is a safe option with predictable outcome for persons who have recently received endodontic therapy. The anterior teeth, predominantly incisors, were more susceptible to minimal EARR than premolars, which suggests that the rate of EARR occurrence may depend upon the original morphology of the apical portion of the root. The use of additional orthodontic forces increases the risk of EARR and is associated with a higher incidence of radiologically detected PDL space widening.
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Kurnaz S, Buyukcavus MH. External root resorption in root-filled and vital teeth after extraction and non-extraction orthodontic treatments: a split-mouth retrospective study. Acta Odontol Scand 2021; 79:282-288. [PMID: 33171055 DOI: 10.1080/00016357.2020.1842903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to compare the amounts of external root resorption (ERR) during different modalities of orthodontic treatment (OT) in root-filled teeth (RFT) and their contralateral teeth with vital pulp (VPT) in the same patient. MATERIAL AND METHODS The study sample consisted of 69 patients in two groups: 35 patients in the non-extraction group (18 female, 17 male; 18.16 ± 3.79 years), and 34 patients in the extraction group (19 female, 15 male; 17.72 ± 2.78 years). Digital panoramic radiographs of each patient taken before and after OT were used to measure the tooth length and root surface area. The amounts of ERR in RFT and contralateral VPT were evaluated pre- and post-OT in mandibular molars. The data were statistically analyzed with the paired t-test, independent t-test, and analysis of covariance (ANCOVA) (p < .05). RESULTS A statistically significant difference was observed in both the orthodontic treatment groups when RFT and VPT were compared in terms of ERR (p < .05). A significant difference was observed between RFT and VPT in extraction treatments when the reduction in the root area between the two sides in the groups was compared (p < .05). CONCLUSIONS RFT are more resistant to ERR than VPT. The ERR in RFT may not be a significant matter for the planning of OT.
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Affiliation(s)
- Safa Kurnaz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
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17
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Abbing A, Koretsi V, Eliades T, Papageorgiou SN. Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis. Prog Orthod 2020; 21:37. [PMID: 33015719 PMCID: PMC7533275 DOI: 10.1186/s40510-020-00334-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/13/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents. MATERIALS AND METHODS Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. RESULTS A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = - 0.8 month; 95% CI = - 4.2 to 2.6 months; P = 0.65; I2 = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias. CONCLUSIONS While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies. TRIAL REGISTRATION PROSPERO: ( CRD42019148169 ).
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Affiliation(s)
- Allen Abbing
- Clinic of Orthodontics and Pediatric Dentistry Center of Dental Medicine, University of Zurich, Plattenstrasse, 11, Zurich, Switzerland
| | - Vasiliki Koretsi
- Clinic of Orthodontics and Pediatric Dentistry Center of Dental Medicine, University of Zurich, Plattenstrasse, 11, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry Center of Dental Medicine, University of Zurich, Plattenstrasse, 11, Zurich, Switzerland
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry Center of Dental Medicine, University of Zurich, Plattenstrasse, 11, Zurich, Switzerland.
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Bi C, Zhou M, Han X, Zhang Y, Zheng P. Endodontic Microsurgery with Orthodontic Treatment in a Mandibular Left Molar with Symptomatic Apical Periodontitis. J Endod 2020; 46:1799-1805. [PMID: 32795550 DOI: 10.1016/j.joen.2020.07.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 01/04/2023]
Abstract
Endodontic microsurgery has reduced the degree of treatment trauma compared with traditional apical surgery and further increased the success rate of natural teeth retention. However, when root apices of the mandibular posterior teeth are far from the buccal cortical bone surface or near to the inferior alveolar nerve, the operational difficulty of endodontic microsurgery increased greatly. Orthodontic treatments may be helpful to decrease the difficulties. In this case, the roots of a highly calcified mandibular molar diagnosed as previously initiated, symptomatic apical periodontitis were moved initially buccally by orthodontic treatment in 2 months. Then, endodontic microsurgery was completed. The tooth remained asymptomatic and functional with a radiographically healing periapical lesion at the 4-, 12-, and 24-month follow-ups.
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Affiliation(s)
- Cheng Bi
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China; VIP Center, Hangzhou Stomatology Hospital, Hangzhou, China
| | - Mengting Zhou
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xu Han
- VIP Center, Hangzhou Stomatology Hospital, Hangzhou, China
| | - Yu Zhang
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China
| | - Pei Zheng
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China.
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Reply. J Endod 2020; 46:1009-1010. [PMID: 32381267 DOI: 10.1016/j.joen.2020.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/17/2020] [Indexed: 11/20/2022]
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Fernandes LQP, Figueiredo NC, Montalvany Antonucci CC, Lages EMB, Andrade I, Capelli Junior J. Predisposing factors for external apical root resorption associated with orthodontic treatment. Korean J Orthod 2019; 49:310-318. [PMID: 31598487 PMCID: PMC6769259 DOI: 10.4041/kjod.2019.49.5.310] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/05/2019] [Accepted: 05/24/2019] [Indexed: 11/10/2022] Open
Abstract
Objective This study aimed to identify possible risk factors for external apical root resorption (EARR) in the maxillary incisors after orthodontic treatment. Methods The root length of 2,173 maxillary incisors was measured on periapical radiographs of 564 patients who received orthodontic treatment. The Kappa test was performed to evaluate intraexaminer and interexaminer reproducibility. Multiple binary logistic regression was used to determine the association between EARR and various factors. Odds ratios and 95% confidence intervals were reported. Results The risk of developing EARR was 70% higher in orthodontic treatment with maxillary premolar extraction (p = 0.004), 58% higher in patients with increased overjet (p = 0.012), 41% lower in two-phase orthodontic treatment (p = 0.037), and 33% lower in patients with deep bite (p = 0.039). The lateral incisors were 54% more likely to develop EARR (p < 0.001), dilacerated roots were 2.26 times more likely to develop EARR (p < 0.001), and for each additional millimeter of root length, the risk of EARR increased by 29% (p < 0.001). Conclusions The potential risk factors for EARR after orthodontic treatment included treatment with maxillary premolar extraction, increased overjet at the beginning of treatment, and dilacerated roots.
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Affiliation(s)
| | - Natália Couto Figueiredo
- Department Of Orthodontics, School Of Dentistry, Pontifical Catholic University Of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Ildeu Andrade
- Department Of Orthodontics, School Of Dentistry, Pontifical Catholic University Of Minas Gerais, Belo Horizonte, Brazil
| | - Jonas Capelli Junior
- Department of Orthodontics, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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21
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Kolcuoğlu K, Oz AZ. Comparison of orthodontic root resorption of root-filled and vital teeth using micro-computed tomography. Angle Orthod 2019; 90:56-62. [PMID: 31306075 DOI: 10.2319/022819-153.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the difference in orthodontic root resorption between root-filled and vital teeth. MATERIAL AND METHODS Sixteen individuals who required bilateral premolar tooth extraction due to orthodontic treatment and had a previously root-filled premolar tooth on one side were included in the study. The experimental group consisted of root-filled premolar teeth, and the control group consisted of contralateral vital premolar teeth. A 150-g buccally directed force was applied to these teeth using 0.017 × 0.025-inch TMA cantilever springs. The premolars were extracted 8 weeks after the application of force. Images were obtained using micro-computed tomography. Resorption measurements were obtained using the Image J program. RESULTS The mean values for resorption were 0.08869 mm3 for the root-filled teeth and 0.14077 mm3 for the contralateral teeth, indicating significantly less resorption for the root-filled teeth compared with the contralateral teeth after the application of orthodontic force (P = .003). In both groups, the most resorption was seen on the cervical-buccal and apical-lingual surfaces. The mean resorption value of the cervical region was 0.06305 mm3 in the control group and 0.0291 mm3 in the experimental group, and the difference was statistically significant (P = .002). CONCLUSIONS Root-filled teeth showed significantly less orthodontic root resorption than vital teeth.
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Orthodontic-induced External Root Resorption of Endodontically Treated Teeth: A Meta-analysis. J Endod 2019; 45:483-489. [DOI: 10.1016/j.joen.2019.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 01/25/2019] [Accepted: 02/01/2019] [Indexed: 11/22/2022]
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Wang Y, Zhang H, Sun W, Wang S, Zhang S, Zhu L, Chen Y, Xie L, Sun Z, Yan B. Macrophages mediate corticotomy-accelerated orthodontic tooth movement. Sci Rep 2018; 8:16788. [PMID: 30429494 PMCID: PMC6235963 DOI: 10.1038/s41598-018-34907-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/26/2018] [Indexed: 12/25/2022] Open
Abstract
Clinical evidence has suggested that surgical corticotomy of the alveolar bone can accelerate local orthodontic tooth movement (OTM), but the underlying cell and molecular mechanisms remain largely unclear. The present study examined the role of macrophages played in corticotomy-assisted OTM. Orthodontic nickel-titanium springs were applied to the left maxillary first molars of rats or mice to induce OTM with or without corticotomy. Corticotomy enhanced OTM distance by accelerating movement through induction of local osteoclastogenesis and macrophage infiltration during OTM. Further analysis showed that macrophages were polarized toward an M1-like phenotype immediately after corticotomy and then switched to an M2-like phenotype during OTM. The microenvironment of corticotomy induced macrophage infiltration and polarization through the production of TNF-α. More importantly, the amount of OTM induced by corticotomy was significantly decreased after mice were depleted of monocyte/macrophages by injection of liposome-encapsulated clodronate. Further experiments by incubating cultured macrophages with fresh tissue suspension obtained from post-corticotomy gingiva switched the cells to an M1 phenotype through activation of the nuclear factor-κB (NF-κB) signaling pathway, and to an M2 phenotype through activation of the JAK/STAT3 signaling pathway. Our results suggest that corticotomy induces macrophage polarization first by activating the NF-κB signaling pathway and later by activating the JAK/STAT3 signaling pathway, and that these processes contribute to OTM by triggering production of inflammatory cytokines and osteoclastogenesis.
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Affiliation(s)
- Yan Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Science & Technology Town Hospital, 215153, Suzhou, Jiangsu Province, China
| | - Hanwen Zhang
- School of Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Wen Sun
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Siyu Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Shuting Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Linlin Zhu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Yali Chen
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Lizhe Xie
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Zongyang Sun
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, USA
| | - Bin Yan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China. .,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
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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. [PMID: 30895094 PMCID: PMC6388840 DOI: 10.1016/j.jds.2017.09.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 09/17/2017] [Indexed: 02/05/2023] Open
Abstract
Background/purpose The application of removable aligner in orthodontic treatment has increased rapidly in recent years, while its effects on root resorption remains unclear. The aim of this study was to comparatively evaluate the amount of external apical root resorption (EARR) in non-extraction patients receiving clear aligner therapy (CAT) or fixed orthodontic treatment (FOT). Materials and methods Eighty non-extraction patients treated with CAT or FOT exclusively were evaluated retrospectively. Panoramic radiographs were used to measure the length of crowns and roots of the incisors before and after treatment. The amount of EARR was determined by the relative change of root-crown ratio and compared between the two groups. The potential predictive factors of EARR were investigated using spearman correlation analysis. Results The overall EARR in the CAT patients was significantly less than the FOT. Similar results were observed in maxillary central incisors, maxillary lateral incisors, mandibular central incisors and mandibular lateral incisors. The duration of treatment positively correlated with the amount of EARR in both modalities. Gender, age, skeletal pattern or degree of malocclusion did not affect the occurrence of EARR. Conclusion Clear aligner therapy may have a superiority of reducing external apical root resorption compared to fixed orthodontic treatment in non-extraction patients.
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Affiliation(s)
- Jianru Yi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiani Xiao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yu Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaobing Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Ahlbrecht CA, Ruellas ACDO, Paniagua B, Schilling JA, McNamara JA, Cevidanes LHS. Three-dimensional characterization of root morphology for maxillary incisors. PLoS One 2017; 12:e0178728. [PMID: 28594852 PMCID: PMC5464764 DOI: 10.1371/journal.pone.0178728] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/17/2017] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to test the reproducibility of three-dimensional (3D) surface models of maxillary incisors and to propose a characterization of root morphology. The sample was comprised of pre-treatment cone-beam computed tomography (CBCT) images of fifty-five patients. The CBCTs were used to construct 3D surface models of the maxillary incisors. The reproducibility of surface models was tested by repeated construction of them by two observers. A 3D surface model that corresponded to the average of all lateral and all central incisors was generated. 3D surface distances and vector differences were calculated for each individual tooth and the average of the teeth considered. The corresponding points on the 3D surface mesh for each subgroup were compared statistically to those of the neutral subgroup using shape analysis MANCOVA and Hotelling's t-statistic (p < 0.05). Repeated construction of surface models demonstrated adequate inter-rater reproducibility. The distribution of 3D models into root morphology subgroups was: blunt (11% and 26% of the central and lateral incisors, respectively), conical (15% of the central incisors), long (27% and 20% of the central and lateral incisors, respectively), and short (15% and 4% of the central and lateral incisors, respectively). Compared to the neutral average, statistically significant differences in root morphology were found for blunt, long, conical, and short central incisors and for blunt, long, and short lateral incisors. We can conclude that 3D surface models construction for upper incisors is reproducible. 3D shape analysis using CBCT images allows a phenotypic characterization of incisor root morphology.
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Affiliation(s)
- Carly A. Ahlbrecht
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Antonio Carlos de Oliveira Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Orthodontics and Pediatric Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Beatriz Paniagua
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Juan A. Schilling
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Lucia Helena Soares Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
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Impact of cone-beam computed tomography scan mode on the diagnostic yield of chemically simulated external root resorption. Am J Orthod Dentofacial Orthop 2017; 151:1073-1082. [PMID: 28554453 DOI: 10.1016/j.ajodo.2016.10.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The aim of this in-vitro study was to evaluate the influence of cone-beam computed tomography scans on the diagnosis of chemically simulated external root resorption. METHODS One hundred extracted anterior teeth were selected. Subsurface demineralization was induced on a limited area of the apical third of the root of 49 teeth. Each tooth was placed in an empty socket of a partially edentulous dry mandible. Cone-beam computed tomography images were obtained according to 3 protocols: (1) half scan, 0.40-mm voxel size; (2) full scan, 0.40-mm voxel size; and (3) full scan, 0.125-mm voxel size. Three observers evaluated the images. Sensitivity, specificity, accuracy, and area under the curve were compared with the Cochran Q and Mann-Whitney U tests. RESULTS Protocol 3 had the highest sensitivity (81.63%), accuracy (80.67%), and area under the curve (0.807). There were statistically significant differences between protocol 3 and the other 2 protocols (P <0.001). The specificity of protocol 1 (84.97%) was greater than that of protocols 2 (69.93%) and 3 (79.74%); however, a statistically significant difference was found only between protocols 1 and 2 (P = 0.005). CONCLUSIONS A more dedicated, high-resolution scan should be acquired when one intends to investigate the early stage of external root resorption during orthodontic treatment. However, this does not imply that all orthodontic patients should be subjected to high-dose cone-beam computed tomography scans.
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