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The Cochrane Database of Systematic... Nov 2015External root resorption is a pathological process, which tends to occur following a wide range of mechanical or chemical stimuli such as infection, pressure, trauma or... (Review)
Review
BACKGROUND
External root resorption is a pathological process, which tends to occur following a wide range of mechanical or chemical stimuli such as infection, pressure, trauma or orthodontic tooth movement. Although it is predominantly detected by radiography, in some cases root resorption may be identified by clinical symptoms such as pain, swelling and mobility of the tooth. Treatment alternatives are case-dependent and aim to address the cause of the resorption and aid the regeneration of the resorptive lesion.
OBJECTIVES
To evaluate the effectiveness of any interventions that can be used in the management of external root resorption in permanent teeth.
SEARCH METHODS
The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 14 October 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 9), MEDLINE via OVID (1946 to 14 October 2015) and EMBASE via OVID (1980 to 14 October 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials of permanent teeth with any type of external root resorption, which has been confirmed by clinical and radiological examination, comparing one type of intervention (root canal medications and canal filling, splinting or extraction of teeth or the surgical removal of any relevant pathology) with another, or with placebo or no treatment.
DATA COLLECTION AND ANALYSIS
Two review authors screened search records independently. Full papers were obtained for potentially relevant trials. If data had been extracted, the statistical guidelines set out in the Cochrane Handbook would have been followed.
MAIN RESULTS
No randomised controlled trials that met the inclusion criteria were identified. However, we identified one ongoing study that is potentially relevant to this review and will be assessed when it is published.
AUTHORS' CONCLUSIONS
We were unable to identify any reports of randomised controlled trials regarding the efficacy of different interventions for the management of external root resorption. In view of the lack of reliable evidence on this topic, clinicians must decide on the most appropriate means of managing this condition according to their clinical experience with regard to patient-related factors. There is a need for well designed and conducted clinical trials on this topic, which conform to the CONSORT statement (www.consort-statement.org/).
Topics: Dentition, Permanent; Humans; Root Resorption
PubMed: 26599212
DOI: 10.1002/14651858.CD008003.pub3 -
International Journal of Molecular... Feb 2021The aim of this paper is to provide a review on the role of inflammation in orthodontically induced inflammatory root resorption (OIIRR) and accelerating orthodontic... (Review)
Review
The aim of this paper is to provide a review on the role of inflammation in orthodontically induced inflammatory root resorption (OIIRR) and accelerating orthodontic tooth movement (AOTM) in orthodontic treatment. Orthodontic tooth movement (OTM) is stimulated by remodeling of the periodontal ligament (PDL) and alveolar bone. These remodeling activities and tooth displacement are involved in the occurrence of an inflammatory process in the periodontium, in response to orthodontic forces. Inflammatory mediators such as prostaglandins (PGs), interleukins (Ils; IL-1, -6, -17), the tumor necrosis factor (TNF)-α superfamily, and receptor activator of nuclear factor (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) are increased in the PDL during OTM. OIIRR is one of the accidental symptoms, and inflammatory mediators have been detected in resorbed roots, PDL, and alveolar bone exposed to heavy orthodontic force. Therefore, these inflammatory mediators are involved with the occurrence of OIIRR during orthodontic tooth movement. On the contrary, regional accelerating phenomenon (RAP) occurs after fractures and surgery such as osteotomies or bone grafting, and bone healing is accelerated by increasing osteoclasts and osteoblasts. Recently, tooth movement after surgical procedures such as corticotomy, corticision, piezocision, and micro-osteoperforation might be accelerated by RAP, which increases the bone metabolism. Therefore, inflammation may be involved in accelerated OTM (AOTM). The knowledge of inflammation during orthodontic treatment could be used in preventing OIIRR and AOTM.
Topics: Animals; Humans; Inflammation; Osteogenesis; Root Resorption; Tooth Movement Techniques
PubMed: 33673606
DOI: 10.3390/ijms22052388 -
International Endodontic Journal Nov 2022External inflammatory lateral resorption (EILR) following dental trauma is a severe complication that can lead to significant root loss and tooth extraction. (Review)
Review
BACKGROUND
External inflammatory lateral resorption (EILR) following dental trauma is a severe complication that can lead to significant root loss and tooth extraction.
OBJECTIVE
The aim of this project was to review current evidence in the literature on regenerative endodontic therapy (RET) for EILR following traumatic injuries and assess the best treatment practices.
METHODS
Publications appearing in PubMed, from January 1, 2001 to January 9, 2022 were studied. Inclusion criteria were: (a) Publications in English; (b) Publications on RET and EILR; (c) Teeth subjected to dental trauma; and (d) Presence of intracanal bleeding and blood clots. Exclusion criteria were: (a) Conference proceedings; (b) Lectures; (c) Abstracts; and (d) Letters to editor; (e) Non-English publications.
RESULTS
355 publications were analysed. Nine met all inclusion criteria. In 10 (58.8%) teeth, triple antibiotic paste was used for an average of 26 days. Double antibiotic paste was used in 3 (17.6%) teeth for an average of 14 days. In 3 (17.6%) cases, calcium hydroxide (Ca(OH) ) was used for 14 days and negative pressure irrigation was applied once on 1 (6%) tooth.
DISCUSSION
Using RET to treat EILR has some advantages compared to long term CA(OH) dressing. RET requires shorter dressing time compared to CA(OH) . This can significantly improve patient compliance. Additionally, in immature teeth, RET helps to arrest root resorption leading to continued root maturogenesis and revascularization. It is recommended that a meticulous follow-up should be conducted when RET is performed to assure early detection of treatment failure.
CONCLUSIONS
RET appears to be a good treatment modality producing biologic repair and improving prognosis in cases of EILR in post-traumatic tooth/pulp injuries. The key limitation of this study is that all publications included were either case reports or case series that usually tend to report successful outcome.
Topics: Anti-Bacterial Agents; Biological Products; Calcium Hydroxide; Dental Pulp Necrosis; Humans; Regenerative Endodontics; Root Canal Therapy; Root Resorption; Tooth Injuries
PubMed: 35947093
DOI: 10.1111/iej.13811 -
Journal of Conservative Dentistry : JCD 2015Autogenous tooth transplantation refers to the repositioning of autogenous teeth in another tooth extraction site or a surgically formed recipient site to replace...
Autogenous tooth transplantation refers to the repositioning of autogenous teeth in another tooth extraction site or a surgically formed recipient site to replace missing teeth due to congenital deformity, grossly decayed carious teeth, mobile teeth due to periodontal disease, teeth lost due to trauma, endodontic failure or any other reason when a suitable donor tooth is available. This is a case report of autotransplantation of impacted #38 with complete root formation into the extraction site of grossly decayed, unrestorable #37 with 18 months follow-up showing excellent periapical healing and tooth stability. In autogenous tooth transplantation, even if the donor's tooth has complete root formation, a high success rate can be achieved if the cases are selected and treated properly. Chances of root resorption are there because of necrotic pulp and periodontal irritation during manipulation. However, autogenous tooth transplantation should always be considered as a good treatment modality in feasible cases.
PubMed: 26752848
DOI: 10.4103/0972-0707.168827 -
Progress in Orthodontics Jan 2020Fixed appliances have been the mainstream for orthodontic treatment, while clear aligners, such as Invisalign system, have become increasingly popular. The prevalence of...
BACKGROUND
Fixed appliances have been the mainstream for orthodontic treatment, while clear aligners, such as Invisalign system, have become increasingly popular. The prevalence of apical root resorption (ARR) in patients with clear aligners is still controversial. The aim of this study was to investigate and compare the prevalence and severity of ARR in patients treated with clear aligners and fixed appliances using cone beam computed tomography (CBCT).
MATERIALS AND METHODS
A total of 373 roots from 70 subjects, with similar baseline characteristics and the ABO discrepancy index scores (i.e., treatment difficulty), were included into two groups: the clear aligners group (Invisalign, Align Technology, California, USA) and fixed appliances group (Victory Series; 3 M Unitek, California, USA). Root length of each anterior tooth was measured on the CBCT images by two blinded investigators. The ARR on each tooth was calculated as the difference of root length before and after orthodontic treatment. Chi-square test and paired t test was used to compare the ARR between the two groups as well as before and after orthodontic treatments.
RESULTS
Prevalence of ARR in the clear aligners group (56.30%) was significantly lower than that in the fixed appliances group (82.11%) (P < 0.001). The severity of ARR in the clear aligners group (0.13 ± 0.47 mm) was significantly less than that in the fixed appliances group (1.12 ± 1.34 mm) (P < 0.001). The most severe ARR was found on the maxillary canine (1.53 ± 1.92 mm) and lateral incisor (1.31 ± 1.33 mm) in the fixed appliances group; the least ARR was found on the mandibular canine (- 0.06 ± 0.47 mm) and lateral incisor (0.04 ± 0.48 mm) in the clear aligners group (P < 0.001).
CONCLUSIONS
The prevalence and severity of ARR measured on CBCT in patients with clear aligners were less than those in patients with fixed appliances.
Topics: Cone-Beam Computed Tomography; Humans; Orthodontic Appliances, Fixed; Orthodontic Appliances, Removable; Prevalence; Root Resorption
PubMed: 31903505
DOI: 10.1186/s40510-019-0301-1 -
Journal of Periodontology Mar 2020Orthodontic treatment can greatly impact the periodontium, especially in dentitions with a thin periodontal phenotype. Orthodontic tooth movement can result into...
BACKGROUND
Orthodontic treatment can greatly impact the periodontium, especially in dentitions with a thin periodontal phenotype. Orthodontic tooth movement can result into iatrogenic sequelae to these vulnerable anatomic conditions, such as development and exacerbation of bony dehiscence or fenestration defects, which can manifest loss of periodontal support and gingival recession (GR). This systematic review aimed to investigate whether periodontal phenotype modification therapy (PhMT) involving hard tissue augmentation (PhMT-b) or soft tissue augmentation (PhMT-s) has clinical benefits for patients undergoing orthodontic treatment.
METHODS
An electronic search was performed in two major databases for journals published in English language from January 1975 to January 2019 and a hand search of printed journals was also performed to identify human clinical trials reporting clinical and radiographic outcomes of patients receiving orthodontic treatment with or without hard and soft tissue augmentation procedures. Data were extracted and organized into tables for qualitative assessment.
RESULTS
Eight studies were identified evaluating the outcomes of PhMT in patients undergoing orthodontic therapy. Six studies evaluated patients receiving PhMT-b via corticotomy-assisted orthodontic therapy (CAOT) and simultaneous bone augmentation while the other two received PhMT-s before tooth movement. No studies investigated PhMT-b alone without CAOT and most studies focused on the mandibular anterior decompensation movements. There was high heterogeneity in the study design and inconsistency of the reported outcomes; therefore, a meta-analysis was not performed. Evidence at this moment supports CAOT with hard tissue augmentation accelerated tooth movement. However, only two studies provided direct comparison to support that CAOT with PhMT-b reduced the overall treatment time compared with conventional orthodontic treatment. No periodontal complications or evidence of severe root resorption were reported for both groups. Four studies provided radiographic assessment of the PhMT-b and demonstrated increased radiographic density or thicker facial bone after the treatment. Two studies reported an expanded tooth movement. One study reported an increase in keratinized tissue width post-CAOT plus PhMT-b, while another study with a 10-year follow-up showed a lower degree of relapse using the mandibular irregularity index when compared with conventional tooth movement alone. Two studies examined the effect of PhMT-s before orthodontic treatment. Unfortunately, no conclusions can be drawn because of the limited number of studies with contradicting outcomes.
CONCLUSIONS
Within the limited studies included in this systematic review, PhMT-b via particulate bone grafting together with CAOT may provide clinical benefits such as modifying periodontal phenotype, maintaining or enhancing facial bone thickness, accelerating tooth movement, expanding the scope of safe tooth movement for patients undergoing orthodontic tooth movement. The benefits of PhMT-s alone for orthodontic treatment remain undetermined due to limited studies available. However, PhMT-b appears promising and with many potential benefits for patients undergoing orthodontic tooth movement. There is a need for a higher quality of randomized controlled trials or case control studies with longer follow-up to investigate the effects of different grafting materials and surgical sites other than mandibular anterior region.
Topics: Bone Transplantation; Gingival Recession; Humans; Phenotype; Root Resorption; Tooth Movement Techniques; United States
PubMed: 31670836
DOI: 10.1002/JPER.19-0037 -
Journal of Istanbul University Faculty... 2017Contemporarily, the ravages of tooth resorption are seen daily around the world. While some teeth can be retained many are lost to this process. Although many types of... (Review)
Review
Contemporarily, the ravages of tooth resorption are seen daily around the world. While some teeth can be retained many are lost to this process. Although many types of resorptive processes have been identified, the etiological factors involved in this malady are not often clear and both speculation as to it source and clinical management have received a great deal of empirical explanations and directives, respectively. However, this was not always the case, as the nature of tooth resorption, as is known today, was not really addressed in a significant manner until the mid-1970s. In fact, when first identified as a problem in the early 1800s, the term resorption did not even exist and the process was poorly understood. This historical review of tooth resorption will trace the evolution of some of our ideas about this malady, identifying both the concepts and personalities involved in this evolution.
PubMed: 29354305
DOI: 10.17096/jiufd.14022 -
Progress in Orthodontics Mar 2021This review synthesizes the available evidence about the predisposition of individuals with asthma or allergies to orthodontically induced inflammatory root resorption... (Review)
Review
BACKGROUND
This review synthesizes the available evidence about the predisposition of individuals with asthma or allergies to orthodontically induced inflammatory root resorption (OIIRR) and possible factors related to root resorption that were investigated in the included studies, such as the type of malocclusion, duration of orthodontic treatment, and tooth units.
MATERIAL AND METHODS
Six electronic databases and partial gray literature were searched without date or language restrictions until September 2020. Prospective and retrospective observational cohort and case-control studies were included. The risk of bias (RoB) was assessed using the checklists from the Joanna Briggs Institute and the certainty of the evidence using the GRADE tool. To complement the case-control studies, the odds ratio (OR) of the individuals with allergies/asthma to develop root resorption was calculated.
RESULTS
Six studies were included. One study with low RoB, one with moderate, and one with high RoB stated that allergic patients did not report a greater chance of developing OIIRR (OR = 1.17 to 2.10, p = 0.1 to 1), while only one study with low RoB reported that individuals with allergies tend to develop root resorption (OR = 2.4, 95% CI = 1.08-5.37). Three studies with low RoB and one with moderate showed no significant association between asthma and OIIRR (OR = 1.05 to 3.42, p = 0.12 to 0.94). No association was identified between the type of malocclusion and the degree of OIIRR. Uniradicular dental units and a prolonged treatment time seem to be associated with an increased risk of resorption. The certainty of the evidence was considered low for both exposure factors.
CONCLUSION
Evidence with a low level of certainty indicates that individuals with allergies or asthma are not more predisposed to OIIRR. Uniradicular teeth and long-term orthodontic treatments are associated with a higher risk of OIIRR.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42020188463.
Topics: Asthma; Humans; Malocclusion; Prospective Studies; Retrospective Studies; Root Resorption; Tooth Movement Techniques
PubMed: 33718992
DOI: 10.1186/s40510-021-00351-x -
Australian Dental Journal Mar 2017Root resorption can occur at any time during orthodontic treatment and lead to a compromise in the prognosis of the tooth and the stability of the treatment results.... (Review)
Review
Root resorption can occur at any time during orthodontic treatment and lead to a compromise in the prognosis of the tooth and the stability of the treatment results. Recent research has focused more on the cause and effect relationship as well as preventive or treatment options to combat this unwelcome event. Investigations have highlighted the genetic as well as molecular aspects of the process and enabled clinicians to determine which patients might be susceptible. A proper medical history, an assessment of predisposing factors, a radiographic evaluation for alterations in root morphology and careful planning and execution of orthodontic mechanics may reduce the incidence of root resorption. The current review is aimed at providing clinicians and academics with an insight into the process of root resorption, the methods of identification during its early stages and intervention at the right time to reduce its severity.
Topics: Humans; Malocclusion; Orthodontics, Corrective; Root Resorption; Tooth Movement Techniques
PubMed: 28297086
DOI: 10.1111/adj.12483 -
L' Orthodontie Francaise Dec 2018
Topics: Age Factors; Animals; Comorbidity; Humans; Orthodontics; Radiography, Panoramic; Rats; Risk Factors; Tooth Resorption
PubMed: 30565552
DOI: 10.1051/orthodfr/2018031