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Genetic variation involved in the risk to external apical root resorption in orthodontic patients: a systematic review. Clin Oral Investig 2021; 25:5613-5627. [PMID: 34392402 DOI: 10.1007/s00784-021-04074-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/08/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To perform a systematic review/meta-analysis to elucidate the scientific basis for the association between genetic variations and risk of external apical root resorption (EARR) in orthodontic patients. MATERIALS AND METHODS Four databases (PubMed, Web of Science, Scopus, LILACS) were electronically searched until November 22, 2020, followed by manual and gray literature search. Case-control or cross-sectional studies that evaluated genes involved in the susceptibility of orthodontic patients to EARR were eligible. Two reviewers applied the inclusion and exclusion criteria, extracted qualitative data, as well as assessed methodological quality using instrument proposed for genetic studies. For synthesis results, narrative and quantitative data (meta-analysis) were performed. The certainty of the evidence was tested using the GRADE Working Group approach. RESULTS Of 201 articles in total, 16 studies were included in the review. Of these, 11 presented moderate and 5 of high methodological quality. In the narrative analysis, from 16 studies, 15 studies (10 genes) showed a significant association with EARR and 9 studies were included in the meta-analysis. Only the polymorphism rs208294 in P2RX7 (dominant model) was associated with EARR (OR = 0.52, 95%CI = 0.29-0.95, p = 0.03) and presented a very low certainty of the evidence. CONCLUSION Narrative analyses of individual studies demonstrated an association of many genes. The number of studies for each genetic variation was very low, and methodological heterogeneity between the studies was observed. Quantitative analyses (meta-analysis) could only show an involvement for P2RX7 (rs208294) in the risk of orthodontic patients to EARR at a very low certainty of evidence. (CRD42018085411). CLINICAL RELEVANCE The knowledge regarding the molecular aspects involved in the etiology of EARR will allow orthodontists to use a personalized treatment and early diagnosis of risk patients. This systematic review demonstrates that more studies are necessary to unravel the role of genetic variation for patients' risk to EARR during orthodontic tooth movement.
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Nowrin SA, Jaafar S, Rahman NA, Shahid F, Basri R, Alam MK. External Apical Root Resorption and IL-1A, IL-1RN Gene Polymorphisms: A Systematic Review and Meta-Analysis of Prospective Studies. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Yassir YA, McIntyre GT, Bearn DR. Orthodontic treatment and root resorption: an overview of systematic reviews. Eur J Orthod 2020; 43:442-456. [PMID: 33215186 DOI: 10.1093/ejo/cjaa058] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Root resorption can be considered the most unfortunate complication of orthodontic treatment. OBJECTIVE To evaluate the available evidence regarding orthodontically induced inflammatory root resorption (OIIRR). SEARCH METHODS A comprehensive literature search was conducted for the systematic reviews investigating OIIRR published up to 24 May 2020. This was accomplished using electronic databases: MEDLINE via OVID, EMBASE, AMED (Allied and Complementary Medicine Database), PubMed, and Web of Science. Any ongoing systematic reviews were searched using Prospero and a grey literature search was undertaken using Google Scholar and OpenGrey (www.opengrey.eu/). No language restriction was applied. SELECTION CRITERIA Only studies investigating OIIRR were included. DATA COLLECTION AND ANALYSIS Screening, quality assessment [using the AMSTAR 2 tool (A Measurement Tool to Assess Systematic Reviews)], and data extraction were performed by two authors independently. Information was categorized and narratively synthesized for the key findings from moderate and high-quality reviews. RESULTS A total of 2033 potentially eligible studies were identified. After excluding the non-relevant studies, 28 systematic reviews were included. Of which, 20 systematic reviews (71.5%) were of moderate and high-quality level of evidence. The incidence and severity of OIIRR increase with the fixed appliance, especially with heavy force, intrusion, torqueing movements, increased treatment duration, and treatment with extractions or with long apical displacement (particularly for maxillary incisors). There was insufficient evidence regarding most other treatment- and patient-related factors on OIIRR. Following all precautionary measures, pausing treatment and regular monitoring benefits patients with OIIRR. CONCLUSIONS AND IMPLICATIONS There is a limited number of high-quality studies in terms of OIIRR. The influence of fixed appliance on root resorption was noted; however, the cause and effect relationship between OIIRR and orthodontic biomechanics has not been confirmed. Avoiding heavy, continuous forces and a greater amount of apical displacement over a long duration of treatment is recommended. Precautionary measures should be carefully considered when treating patients with a high risk of OIIRR. REGISTRATION CRD42020166629.
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Affiliation(s)
- Yassir A Yassir
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq.,Orthodontic Department, School of Dentistry, University of Dundee, UK
| | - Grant T McIntyre
- Orthodontic Department, School of Dentistry, University of Dundee, UK
| | - David R Bearn
- Orthodontic Department, School of Dentistry, University of Dundee, UK
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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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Antagonistic effect of IL1 variants in periodontitis and external apical root resorption: Evidence from a literature review. Arch Oral Biol 2018; 95:195-201. [DOI: 10.1016/j.archoralbio.2018.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/13/2018] [Accepted: 08/14/2018] [Indexed: 01/07/2023]
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Nowrin SA, Jaafar S, Ab Rahman N, Basri R, Alam MK, Shahid F. Association between genetic polymorphisms and external apical root resorption: A systematic review and meta-analysis. Korean J Orthod 2018; 48:395-404. [PMID: 30450332 PMCID: PMC6234115 DOI: 10.4041/kjod.2018.48.6.395] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/26/2018] [Accepted: 07/04/2018] [Indexed: 01/06/2023] Open
Abstract
Objective To date, only a few studies have investigated the relationships between genetic polymorphisms and external apical root resorption (EARR). Hence, the aim of this systematic review was to explore the relationship between different gene polymorphisms and their association with EARR. Methods A complete literature search was conducted by two independent reviewers. The PubMed, Science Direct, and Scopus databases were searched. In addition, the bibliographies of all textbooks and relevant articles were searched manually. A meta-analysis was performed using data entered into the electronic databases until February 28, 2017. Results On the basis of the search, we identified 17 and 7 publications for the systematic review and meta-analysis, respectively. Odds ratio (OR) was used to evaluate the association of the interleukin 1B (+3954) polymorphism and the risk of EARR. The overall OR from the studies was used to estimate the risk of EARR. However, no association was found and no publication bias was apparent for the risk of EARR in patients receiving orthodontic treatment. Conclusions More research on the relationship between gene polymorphism and EARR is necessary to determine better specificity of possible interactions.
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Affiliation(s)
- Shifat A Nowrin
- Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Saidi Jaafar
- Craniofacial Biology Research Group, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Norma Ab Rahman
- Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Rehana Basri
- Department of Medicine, College of Medicine, Al Jouf University, Sakaka, Saudi Arabia
| | | | - Fazal Shahid
- Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Sojod B, Chateau D, Mueller CG, Babajko S, Berdal A, Lézot F, Castaneda B. RANK/RANKL/OPG Signalization Implication in Periodontitis: New Evidence from a RANK Transgenic Mouse Model. Front Physiol 2017; 8:338. [PMID: 28596739 PMCID: PMC5442248 DOI: 10.3389/fphys.2017.00338] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 05/09/2017] [Indexed: 11/13/2022] Open
Abstract
Periodontitis is based on a complex inflammatory over-response combined with possible genetic predisposition factors. The RANKL/RANK/OPG signaling pathway is implicated in bone resorption through its key function in osteoclast differentiation and activation, as well as in the inflammatory response. This central element of osteo-immunology has been suggested to be perturbed in several diseases, including periodontitis, as it is a predisposing factor for this disease. The aim of the present study was to validate this hypothesis using a transgenic mouse line, which over-expresses RANK (RTg) and develops a periodontitis-like phenotype at 5 months of age. RTg mice exhibited severe alveolar bone loss, an increased number of TRAP positive cells, and disorganization of periodontal ligaments. This phenotype was more pronounced in females. We also observed dental root resorption lacunas. Hyperplasia of the gingival epithelium, including Malassez epithelial rests, was visible as early as 25 days, preceding any other symptoms. These results demonstrate that perturbations of the RANKL/RANK/OPG system constitute a core element of periodontitis, and more globally, osteo-immune diseases.
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Affiliation(s)
- Bouchra Sojod
- INSERM, UMR-1138, Laboratoire de Physiopathologie Orale Moléculaire, Centre de Recherche des CordeliersParis, France
| | - Danielle Chateau
- INSERM, UMR-1138, Intestine: Nutrition, Barrier, and Diseases Group, Centre de Recherche des CordeliersParis, France
| | - Christopher G Mueller
- Laboratoire Immunologie et Chimie Thérapeutiques, Centre National de la Recherche Scientifique, UPR-9021, Institut de Biologie Moléculaire et Cellulaire, Université de StrasbourgStrasbourg, France
| | - Sylvie Babajko
- INSERM, UMR-1138, Laboratoire de Physiopathologie Orale Moléculaire, Centre de Recherche des CordeliersParis, France
| | - Ariane Berdal
- INSERM, UMR-1138, Laboratoire de Physiopathologie Orale Moléculaire, Centre de Recherche des CordeliersParis, France
| | - Frédéric Lézot
- INSERM, UMR-957, Laboratoire de Physiopathologie de la Résorption Osseuse et Thérapie des Tumeurs Osseuses Primitives, Faculté de Médecine, Université de NantesNantes, France
| | - Beatriz Castaneda
- INSERM, UMR-1138, Laboratoire de Physiopathologie Orale Moléculaire, Centre de Recherche des CordeliersParis, France.,Department of Basic Studies, Faculty of Odontology, University of AntioquiaMedellin, Colombia
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Abstract
When orthodontic patients desire shorter treatment times with aesthetic results and long-term stability, it is important for the orthodontist to understand the potential limitations and problems that may arise during standard and/or technology-assisted accelerated treatment. Bone density plays an important role in facilitating orthodontic tooth movement (OTM), such that reductions in bone density can significantly increase movement velocity. Lifestyle, genetic background, environmental factors, and disease status all can influence a patients' overall health and bone density. In some individuals, these factors may create specific conditions that influence systemic-wide bone metabolism. Both genetic variation and the onset of a bone-related disease can influence systemic bone density and local bone density, such as observed in the mandible and maxilla. These types of localized density changes can affect the rate of OTM and may also influence the risk of unwanted outcomes, i.e., the occurrence of dental external apical root resorption (EARR).
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Affiliation(s)
- Alejandro Iglesias-Linares
- Department of Orthodontics, Complutense University of Madrid, Plaza Ramon y Cajal sn, Phone: +34636705246,
| | - Lorri Ann Morford
- University of Kentucky Center for the Biologic Basis of Oral/Systemic Diseases, 1095 Veterans Administration Drive, HSRB Room 414, Lexington, KY 40536-0305 USA, Phone: 859-323-2595 Fax: 859-257-6566,
| | - James Kennedy Hartsfield
- University of Kentucky Center for the Biologic Basis of Oral/Systemic Diseases, 1095 Veterans Administration Drive, HSRB Room 414, Lexington, KY 40536-0305 USA, Phone: 859-323-0296 Fax: 859-257-6566,
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Iglesias-Linares A, Hartsfield JK. Cellular and Molecular Pathways Leading to External Root Resorption. J Dent Res 2016; 96:145-152. [PMID: 27811065 DOI: 10.1177/0022034516677539] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
External apical root resorption during orthodontic treatment implicates specific molecular pathways that orchestrate nonphysiologic cellular activation. To date, a substantial number of in vitro and in vivo molecular, genomic, and proteomic studies have supplied data that provide new insights into root resorption. Recent mechanisms and developments reviewed here include the role of the cellular component-specifically, the balance of CD68+, iNOS+ M1- and CD68+, CD163+ M2-like macrophages associated with root resorption and root surface repair processes linked to the expression of the M1-associated proinflammatory cytokine tumor necrosis factor, inducible nitric oxide synthase, the M1 activator interferon γ, the M2 activator interleukin 4, and M2-associated anti-inflammatory interleukin 10 and arginase I. Insights into the role of mesenchymal dental pulp cells in attenuating dentin resorption in homeostasis are also reviewed. Data on recently deciphered molecular pathways are reviewed at the level of (1) clastic cell adhesion in the external apical root resorption process and the specific role of α/β integrins, osteopontin, and related extracellular matrix proteins; (2) clastic cell fusion and activation by the RANKL/RANK/OPG and ATP-P2RX7-IL1 pathways; and (3) regulatory mechanisms of root resorption repair by cementum at the proteomic and transcriptomic levels.
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Affiliation(s)
- A Iglesias-Linares
- 1 Department of Orthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - J K Hartsfield
- 2 Oral Health Science, College of Dentistry, University of Kentucky, Lexington, KY, USA
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