Professional Documents
Culture Documents
10.5368/aedj.2015.7.1.4.2
A REVIEW OF ROOT RESORPTION IN ORTHODONTICS
1 1
Venkatesh Nettam Postgraduate student
2 2
Prasad Mandava Professor and Head
3 3
Gowri Sankar Singaraju Professor
4 4
Vivek Reddy Ganugapanta Senior lecturer
1-4
Department of Orthodontics, Narayana Dental College, Nellore, Andhra Pradesh, India.
ABSTRACT: Root resorption is unavoidable, unwanted and undesirable consequence of the orthodontic tooth movement.
This paper describes the various causes, types and classification of root resorption during orthodontic treatment
INTRODUCTION
Bone is not necessarily the only hard tissue The principle cellular elements in the PDL are
resorbed during orthodontic tooth movement. Root undifferentiated mesenchymal cells and their progeny in
resorption involving cementum and dentin can be an the form of fibroblasts and osteoblasts. Remodelling and
1
unfavourable sequel to orthodontic procedures . Apical recontouring of the bony socket and the cementum of the
root resorption is one of the most common iatrogenic root is also constantly being carried out, though on a
6
problems associated with orthodontic treatment. It is smaller scale, as a response to normal function .
becoming an increasingly more serious problem from a
2 6
medico legal stand point . Response to Normal Function : During masticatory
function, the teeth and periodontal structures are
Root shortening as a result of external resorption is a well- subjected to intermittent heavy forces. When a tooth is
documented possible side effect of orthodontic treatment. subjected to heavy loads of this type, quick displacement
It is irreversible, difficult to predict and can be sufficiently of the tooth within the PDL space is prevented by the
extensive to cast doubt on the overall benefit to the patient incompressible tissue fluid. Instead the force is transmitted
3
of an otherwise successful orthodontic treatment .Root to the alveolar bone, which bends in response. Bone
resorption is undesirable because it can affect the long- bending in response to normal function generates
term viability of the dentition, and reports in the literature piezoelectric currents, which appear to be an important
indicate that patients undergoing orthodontic treatment are stimulus to skeletal regeneration and repair. This is the
4
more likely to have severe apical root shortening . Bates mechanism by which bony architecture is adapted to
(1856) was the first person to discuss root resorption of functional demands. When pressure on tooth is applied
permanent teeth. Ottolengui (1914) related root resorption for a second, very little of the fluid within the PDL space
directly to orthodontic treatment and mentioned that gets squeezed out. However, if pressure against a tooth is
Schwarzkopf (1887) demonstrated resorbed roots in maintained, the fluid is rapidly expressed and the tooth
extracted permanent teeth. In 1927 root resorption of displaces within the PDL space, compressing the ligament
permanent teeth was a subject of major concern to the itself against adjacent bone. Although the PDL is
orthodontic field. Ketcham, demonstrated with beautifully adapted to resist forces of short duration, it
radiographic evidence, the differences between root shape rapidly loses its adaptive capability as the tissue fluids are
before and after orthodontic treatment. This observation squeezed out of its confined area. Prolonged force, even
initiated a research on histological, clinical and physiologic of low magnitude, produces a different physiologic
5
root resorption occurring during orthodontic treatment . response- remodelling of the adjacent bone. Orthodontic
tooth movement is made possible by the application of
Periodontal and bone response to normal prolonged forces.
function and orthodontic force 6
Effects Of Force Magnitude : When light but prolonged
Each tooth is attached to and separated from the adjacent force is applied to a tooth, blood flow through the partially
alveolar bone by a heavy collageneous supporting compressed PDL decreases as soon as fluids are
6
structure and the periodontal ligament (PDL) . expressed from the PDL space and the tooth moves in its
socket (i.e. in a few seconds). Within a few hours,
10
ACCORDING TO SHAFER, HINE AND LEVY ,
resorption of root occurs in many circumstances other
than the normal process associated with shedding of
deciduous teeth. Resorption of root may occur either on
the external surface or internal surface of the root. Root
resorption is mainly of two types