Root resorption related to orthodontics and other factors: a review of the literature.

Each patient (and parents or guardian) should be clearly informed that there is a real possibility of one or more teeth undergoing root resorption during orthodontic procedures. They should sign an Information and Consent Form arranged by the dentist that they understand these risks before treatment is begun. Open bite cases possess significantly great degrees of resorption. Since trauma is closely associated with root resorption, the patient (and parents or guardian) should be questioned concerning previous traumatic occurrences that involved blows or accidents involving the teeth. Periapical radiographs are an important part of orthodontic records. They are useful to compare pretreatment and posttreatment root resorption. Maxillary incisors are affected more frequently and to a greater degree than the rest of the teeth during active treatment. Also, root resorption of the upper incisors during the initial 6-9 months of treatment with fixed appliances gives a high risk for continued resorption during the subsequent treatment. Therefore, it would be prudent to take periapical radiographs periodically during treatment. When root resorption is detected during active treatment, a decision must be made as to whether to continue, modify or discontinue the treatment. Extremely heavy forces should be avoided, since they have been shown to produce greater resorption activity. The ectopic eruption of canines causes a significant number of resorptions in lateral incisors. Habits adversely affect root resorption and should be eliminated if possible. Pathological lesions increase the risk of resorption. Periodontal disease increases the risk of resorption. The practitioner contemplating doing orthodontics should be cognizant of the above factors in evaluating the risk of root resorption. Patients (and parents or guardians) should be made clearly aware that any type of orthodontic treatment carries with it the risk of root tip blunting or resorption during orthodontic therapy.