Is the presence of severe external apical root resorption a contraindication to orthodontic retraction of maxillary incisors?

This case report details the orthodontic retreatment of an adult patient with a maxillary dentoalveolar protrusion, a 6.0-mm overjet, severe mandibular crowding, and maxillary central incisors exhibiting a short root anomaly. The treatment involved the extraction of premolars, followed by retracting the anterior teeth to improve the patient's profile and smile esthetics and to achieve a balanced occlusion with adequate overbite and overjet. A β titanium-molybdenum alloy 0.019 × 0.025-in archwire with a teardrop loop with 0.5-mm activation was used to ensure lighter forces during the incisors’ retraction. Root resorption was monitored with periapical radiographs throughout the treatment. After four years of comprehensive treatment, satisfactory occlusion, an improved facial profile, and enhanced smile esthetics were achieved. Eight-year follow-up records demonstrate the stability of dental and facial outcomes and the absence of external apical root resorption progression posttreatment. The results confirm the feasibility of orthodontic treatment involving extensive movement of teeth with short root anomaly, provided that precautions such as the application of light forces and radiographic monitoring are maintained.