Research progress on the orthodontic treatment of permanent teeth with incomplete root development
10.12016/j.issn.2096-1456.202660119
- Author:
GENG Rui
1
;
LIU LIU
1
Author Information
1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University
- Publication Type:Review
- Keywords:
orthodontic treatment;
root development;
root resorption;
immature tooth root;
orthodontic treat⁃ment timing;
orthodontic traction of impacted teeth;
biomechanics;
stomatology
- From:
Journal of Prevention and Treatment for Stomatological Diseases
2026;34(10):1033-10444
- CountryChina
- Language:Chinese
-
Abstract:
Malocclusion is one of the most common oral conditions in children and adolescents. To prevent its progression, the demand for earlier orthodontic intervention during the early permanent dentition has been increasing. However, at this stage, the roots of some teeth are not yet fully developed. Whether orthodontic force interferes with the normal development of immature roots or increases the risk of root resorption has long been a controversial issue in clinical practice. Basic research has demonstrated that appropriate orthodontic forces can stimulate periodontal tissue remodeling and activate odontoblastic activity, whereas immature roots exhibit greater stress sensitivity in the apical region. Finite element analyses have indicated that stress distribution varies significantly according to root length and morphology, with short roots and teeth with abnormal root morphology being more prone to stress concentration in the apical area. Clinical studies have generally not observed significant arrest of root development under controlled orthodontic forces; however, individual susceptibility and improper force management may still increase the risk of root resorption. For patients with special orthodontic needs, including impacted tooth traction and craniofacial developmental anomalies, early intervention is often clinically necessary, thereby placing higher demands on the determination of optimal treatment timing. Based on current evidence, incomplete root development should not be regarded as an absolute contraindication to orthodontic treatment. For routine cases, root formation of permanent teeth of approximately 2/3 (around Nolla stage 8) may serve as a reference point for initiating orthodontic treatment. For patients with impacted teeth or craniofacial developmental abnormalities who might otherwise miss the optimal window for intervention, treatment should not be delayed solely because of incomplete apical closure. Instead, individualized decisions should be made based on the stage of root development, the position of the impacted tooth, the direction of traction, and the anticipated benefits. If progressive root resorption or pulpal or periodontal abnormalities occur, orthodontic force should be promptly reduced, suspended, or otherwise adjusted. Future studies should focus on stratified clinical research across different stages of root development and integrate imaging techniques with biological markers to explore dynamic monitoring methods for root development, thereby further optimizing force selection and risk assessment strategies. This review systematically summarizes the biological basis, biomechanical characteristics, and clinical evidence regarding orthodontic treatment in teeth with incomplete root development, aiming to provide further theoretical support for treatment timing selection and individualized clinical decision-making.
- Full text:2026093011081981770牙根发育未完成恒牙正畸治疗的研究进展.pdf
