Internal root resorption is a pathologic phenomenon with a characterization of the intraradicular dentin destruction due to the abnormal activities of odontoclasts. With its insidious pathology, internal root resorption can progress to a great extent before its clinical detection. The etiology and natural history of internal root resorption are uncertain and the associated key molecular pathogenesis have not been understood completely. The resorption is usually initiated by a stimulus with the loss of the protective predentin and progressed by the continuous stimuli of pulp infection. Various factors including trauma, chronic inflammation of the pulp, pulpotomy and tooth transplantation have been proposed for the occurrence of internal root resorption. The present paper reviews the etiology and pathogenesis of internal root resorption and provides guidance for the early intervention in the clinical practice.
Humans ; Pulpotomy ; Root Resorption/etiology*

OBJECTIVES: This study aimed to establish a new treatment of the mandibular second molars with external root resorption caused by impacted teeth to preserve the affected teeth and their vital pulps. METHODS: For mandibular second molars clinically diagnosed as external root resorption caused by impacted teeth, debridement and removal of the root at the resorption site via micro-apical surgery and direct capping of the pulp with bioactive material on the surface of the root amputation via vital pulp therapy were performed immediately after the impacted teeth were extracted. RESULTS: The external root resorption of the affected tooth was ceased. It was asymptomatic with intact crown, normal pulp, periapical alveolar bone reconstruction, normal periodontal ligament, continuous bone sclerosis, and no periapical translucency in radiographic examination at the 1-year postoperative follow-up, thus showing good prognosis. CONCLUSIONS Simultaneous combination of micro-apical surgery and vital pulp therapy after extraction of impacted teeth could successfully preserve mandibular second molars with ERR caused by impacted teeth and their vital pulps.
Humans ; Tooth, Impacted/surgery* ; Molar ; Mandible ; Dental Pulp ; Root Canal Therapy ; Root Resorption/etiology* ; Tooth Extraction

In recent years, developing new methods to accelerate orthodontic tooth movement (OTM) has attracted extensive attention in the field of orthodontic clinical and scientific research. It reduces orthodontic treatment time and risks. Over the past, various approaches have been done to accelerate orthodontic tooth movement. Several forms of corticotomy techniques have been effective in inducing rapid tooth movement. These techniques activate regional acceleratory phenomenon and create a favorable microenvironment for accelerating tooth movement. Root resorption is one of most common side effects of orthodontic treatment. It affects the long-term viability and health of teeth. However, the effect of corticotomy techniques accelerating orthodontic tooth movement on root resorption still remains unclear. Accelerating tooth movement may have two-side effects on root resorption. Through shortening the treatment period and removing the hyalinized tissues, the acceleration of orthodontic tooth movement could reduce root resorption. The increase of root resorption might be due to the local inflammation and function of cementoclasts/odontoclasts. In this paper, we reviewed the effects of different corticotomy techniques accelerating orthodontic tooth movement on root resorption. Corticotomy techniques deal with mucoperio-steal flaps and bone tissues differently and develop towards minimally invasive. Previous studies on root resorption use two-dimensional images, including apical films and panoramic tomography, to evaluate the degree of root resorption. In recent years, researches measure the volume of root resorption accurately using cone-beam computed tomography (CBCT) and micro-CT. Most studies suggest that the root resorption during acceleration of orthodontic tooth movement through corticotomy techniques is not statistically different from that of traditional orthodontic treatment. Some studies using micro-CT have shown that the root resorption in the groups of corticotomy techniques increases compared with the control group without surgery. Because of the short duration of these studies, the clinical significance is controversial on the overall impact of corticotomy techniques on orthodontic treatment. Accelerating orthodontic tooth movement is still at its emerging phase and need further research in the form of clinical trials to illustrate the effect of corticotomy techniques accelerating orthodontic tooth movement on root resorption.
Cone-Beam Computed Tomography ; Humans ; Osteoclasts ; Root Resorption/etiology* ; Tooth Movement Techniques ; Tooth Root ; X-Ray Microtomography

External apical root resorption is among the most common risks of orthodontic treatment, and it cannot be completely avoided and predicted. Risk factors causing orthodontic root resorption can generally be divided into patient- and treatment-related factors. Root resorption that occurs during orthodontic treatment is usually detected by radiographical examination. Mild or moderate root absorption usually does no obvious harm, but close attention is required. When severe root resorption occurs, it is generally recommended to suspend the treatment for 3 months for the cementum to be restored. To unify the risk factors of orthodontic root resorption and its clinical suggestions, we summarized the theoretical knowledge and clinical experience of more than 20 authoritative experts in orthodontics and related fields in China. After discussion and summarization, this consensus was made to provide reference for orthodontic clinical practice.
Humans ; Tooth Movement Techniques/adverse effects* ; Root Resorption/etiology* ; Consensus ; Dental Cementum ; Risk Factors

Humans ; Orthodontics, Corrective ; adverse effects ; Peri-Implantitis ; etiology ; Periodontal Attachment Loss ; etiology ; Risk Management ; Root Resorption ; etiology ; Temporomandibular Joint Disorders ; therapy ; Tooth Root ; injuries

Humans ; Orthodontics, Corrective ; adverse effects ; Risk Factors ; Root Resorption ; etiology ; prevention & control ; Temporomandibular Joint Disorders ; etiology ; prevention & control

BACKGROUNDAnimal models are needed for the study of rapid tooth movement into the extraction socket through distraction osteogenesis of the periodontal ligament.

METHODSModified distraction devices were placed on eight dogs between the first and third mandibular premolars on the left sides; similar placement of traditional straight wise appliances on the right sides served as the control. The experimental distractors were activated (0.25 mm/d) twice a day and the control devices were activated (100 g) for two weeks with consolidation periods at weeks two, three, six, and ten. Two dogs were sacrificed at each consolidation time point; rates and patterns of tooth movement, loss of anchorage, and periapical films were evaluated, and the affected premolars and surrounding periodontal tissues were decalcified and examined histologically. General observations, X-ray periapical filming and histology examination were performed.

RESULTSDistal movement ((3.66+/-0.14) mm) measured two weeks after modified distraction exceeded that achieved using the traditional device ((1.15+/-0.21) mm; P<0.05). Loss of anchorage was minimally averaged (0.34+/-0.06) mm and (0.32+/-0.07) mm in the experimental and control sides, respectively. By radiography, apical and lateral surface root resorptions on both sides were minimal. Alveolar bone lesions were never evident. Fibroblasts were enriched in periodontal ligaments and bone spicules formed actively along directions of distraction.

CONCLUSIONSThe canine model is suitable for the study of rapid tooth movement through distraction osteogenesis of the periodontal ligament. The technique accelerates tooth movement, periodontal remodeling, alveolar bone absorption, and may induce fibroblast formation, as compared to the traditional orthodontic method, without adversely affecting root absorption, bone loss, tooth mobility and anchorage loss.

Animals ; Dogs ; Male ; Osteogenesis, Distraction ; methods ; Periodontal Ligament ; physiology ; surgery ; Root Resorption ; etiology ; Tooth Movement Techniques ; methods

OBJECTIVE: To explore the method of measuring root volume with cone-beam computed tomography (CBCT) three-dimensional reconstruction technology, and to study root length and root volume of upper and lower central incisors in patients with skeletal Class Ⅲ malocclusion treated by surgical orthodontic treatment. METHODS: Twenty patients with skeletal Class Ⅲ malocclusion undergoing surgical orthodontic treatment were selected. CBCT data at three time points, before decompensation treatment (T0), after decompensation treatment (before orthognathic surgery, T1), and the end of post-operative orthodontic treatment (T2) were collected. Three-dimensional reconstruction technology was used to measure the root length and root volume of the upper and lower central incisors (including total root volume, cervical root and apical root), calculate the percentage of reduction volume, and measure the distance of tooth movement after orthodontic treatment. Data were statistically analyzed by SPSS 20.0 software. Least significant difference (LSD) method was used for pair comparison between the groups subject to normal distribution, and non-parametric test was used for comparison between the groups not subject to normal distribution. The differences of root length and root volume of upper and lower incisors were compared, and the characteristics of root absorption were analyzed. RESULTS: Root length and root volume of the upper and lower central incisors were reduced during the surgical orthodontic treatment (P < 0.05) in cases. Both the root volume of cervical root and apical root were significantly reduced (P < 0.05), the reduction of apical root was more significant. The percentage of root volume reduction of the upper central incisor was (30.51±23.23)%, and lower central incisor (23.24±11.96)%. Compared with the upper central incisor, the root volume reduction amount and percentage of the lower central incisor were smaller, and apical root volume reduction of the upper central incisor was greater than that of the lower central incisor, which was statistically significant (P < 0.05). During pre-surgical orthodontic treatment, maxillary central incisor palatal moving was in a controlled tipping manner, and the mandibular central incisor tipped labially. CONCLUSION In patients with skeletal Class Ⅲ malocclusion, root length and total root volume of upper and lower central incisors decreased during surgical orthodontic treatment. Root volume measurement indicated that the cervical root also had root resorption. The difference in root resorption of the upper and lower central incisors might be related to the distance and direction of teeth movement. CBCT three-dimensional reconstruction will compensate for the limitation of root length measurement in evaluating root resorption.
Cone-Beam Computed Tomography/methods* ; Humans ; Incisor/diagnostic imaging* ; Malocclusion, Angle Class III/surgery* ; Maxilla/surgery* ; Root Resorption/etiology*

OBJECTIVETo investigate the effect of the continuous light force to the donor teeth on the periodontal healing after transplantation.

METHODSThirty-two maxillary and mandibular incisors in four 10-month-old male Beagle dogs were autotransplanted. The pulps were removed in all teeth. The teeth were divided into four groups, one control and three experimental groups. In control group (group 1), the teeth were unloaded. In the other three experimental groups, continuous force (0.49 N) was applied in the 1st (group 2), 2nd (group 3) and 4th (group 4) week, respectively. The dogs were sacrificed in the 8th week. The tissue blocks were demineralized and sectioned perpendicular to the long axis of the teeth. The histological analysis was made.

RESULTSHistomophometric analysis revealed a significantly lower occurrence of replacement root resorption in the group 3 (2.1%) than in the control group (12.5%, P < 0.05). The significant lower incidence of replacement root resorption, and a higher surface and inflammatory root resorption were found in group 2 (6.3% and 68.8%) than in the control group (12.5% and 41.7%, P < 0.05). No significant difference was found between group 4 and control group (P > 0.05).

CONCLUSIONSThe orthodontic force promoted the regeneration of the periodontal ligament and prevented dentoalveolar ankylosis, whereas excessive initial force might cause root and bone resorption.

Animals ; Dogs ; Incisor ; transplantation ; Male ; Orthodontic Extrusion ; Periodontal Ligament ; physiology ; Root Resorption ; etiology ; Tooth Replantation ; adverse effects ; Transplantation, Autologous ; Wound Healing

OBJECTIVETo investigate the factors relating to root resorption after orthodontic treatment.

METHODS96 cases treated with fixed appliances were selected. The panoramic radiographs before and after treatment were examined. The relationship between root resorption after treatment (RRAT) and the variables including sex, age, extraction or nonextraction approach, tooth location, treatment duration and the root resorption before treatment (RRBT) were analyzed by multiple variance analysis and stepwise multivariate linear regression analyses.

RESULTS(1) There were statistically significant differences in root resorption in relation to gender (estimate of RRAT for female: 0.41, that for male: 0.34), extraction (estimate of RRAT for the extraction group: 0.43, that for non-extraction: 0.31), anterior or posterior teeth (estimate of RRAT for the anterior teeth: 0.59, that for the posterior teeth: 0.12). (2) The estimate of RRAT for the upper teeth was 0.40, and that for the lower teeth was 0.37. There were no statistically significant differences. (3) Using multiple regression analysis, age, duration and RRBT were associated with RRAT (R = 0.59, R(2) = 0.35).

CONCLUSIONS(1) Factors including gender, extraction or not and anterior or posterior teeth have influences on the RRAT. More root resorption was found in female or extraction cases. Anterior teeth were more susceptible to root resorption relative to posterior teeth. (2) Age, treatment duration and RRBT can explain approximately 35% of the RRAT. Root resorption aggregated when it was present before treatment. The age and treatment duration were lightly related to the root resorption.

Adolescent ; Adult ; Age Factors ; Child ; Female ; Humans ; Male ; Orthodontics, Corrective ; adverse effects ; Regression Analysis ; Root Resorption ; etiology ; Sex Factors ; Time Factors