Apical Resorption of Upper Incisors and Canines During Orthodontic Treatment in Class III Orthognathic Surgery Patients – a Longitudinal Cone Beam Computer Tomography Study

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Summary

Introduction. Although severe root resorption is rare, it is a side effect of orthodontic treatment which affects tooth prognosis. Patients with severe dentofacial deformity, for whom orthodontic treatment and orthognathic surgery was done at the age of 18 and later, had long duration orthodontic treatment and orthognathic surgery, and are at a high risk of root resorption. The impact of orthognathic surgery on root resorption has not been sufficiently studied, and therefore is an interesting topic to research.

Aim of the Study. To identify the risk factors for apical root resorption of maxillary incisors and canines as a result of orthodontic and surgical treatment of Class III malocclusion involving LeFort I osteotomy.

Material and methods. The root lengths of upper incisors and canines were measured on cone beam computer tomography (CBCT) scans obtained from a database of orthognathic surgery patients. As a criteria for root resorption was chosen the difference in root lengths between different time points. The measurements were performed using the scans taken before orthodontic treatment (T1), before surgery (T2), and after post surgery orthodontic treatment (T3), of 28 subjects, aged 20.5 ± 3.81 years, with the mean presurgery treatment time of 19.9 ± 8.8 months, and post-surgery time of 7.1 ± 3.1 months. Changes in root lengths during different time spans were correlated with treatment duration, the initial crown/root ratio, and the severity of dentofacial deformity (Wits appraisal, ANB angle, and overjet).

Results. During T1 - T2 the roots of the lateral incisors shortened by a maximum of 0.78 ± 0.83 mm (p < 0.001), at a rate of 0.04 mm per month. During T2 - T3 the lengths of the central incisor roots decreased most by 0.49 ± 0.52 (p < 0.001) at a rate of 0.07 mm per month. The resorption speed for canines increased from 0.03 mm to 0.1 mm per month before and after surgery. There were statistically significant correlations between the crown-root ratio and the incisor root length (r = 0.319 for lateral and r = 303 for central, both p<0,05) and for canines (r = 482, p<0.01). The associations between the shortened root length, in different time spans for different teeth, and the severity of malocclusion were inconsistent.

Conclusions. Overall, the shortened root length during combined orthodontic and surgical treatment might not be clinically significant. After surgery, the rate of root resorption (mm per month) increased, especially for canines. The teeth with initially shorter roots showed more resorption during treatment.

1. Akyalcin S, Aelxander SP, Silva RM, English JD. Evaluation Of Three-Dimensional Root Surface Changes And Resorption Following Rapid Maxillary Expansion: A Cone Beam Computed Tomography Investigation // Orthodontics & Craniofacial Research, 2015; 18: 117-126

2. Artun J, Smale I, Behbehani F, et al., Apical root resorption six and 12 months after initiation of fixed orthodontic appliance therapy // Orthodontics & Craniofacial Research 2005; 75(6): 919-926

3. Artun J, Van ‘t Hullenaar R, Doppel D, Kuijpers-Jagtman AM. Identification of orthodontic pateints at risk of severe apical root resorption // Americal Journal of Orthodontics and Dentofacial orthopedics, 2009; 135(4): 448-455

4. Castro IO, Alencar AHG, Valladares-Neto J, Estrela C. Aapical root resorption due to orthodontic treatment detected by cone beam computed tomography // Angle Orthodontist, 2013; 83(2): 196 - 203

5. Darendeliler MA, Kharbanda OP, Chan EKM, et al., Root resorption and its association with alterations in physical properies, mineral content and resorption craters in human premolars following application of light and heavy controlled orthodontics forces // Orthodontic and Craniofacial Research, 2004; 7: 79-97

6. Ehsan AA, Rouf Shah SA, Iqtadat S. Frequency Of Root Resorption After First Six Months Of Active Orthodontic Treatment // Medical Channel, 2010; 16(4): 600-606

7. Freitas de CJ, Lyra OCP, de Alencar AHG, Estrela C. Long-Term Evaluation Of Apical Root Resorption After Orthodontic Treatment Using Periapical Radiography And Cone Beam Computed Tomography // Dental Press Journal Of Orthodontics, 2013; 18(4): 104-112

8. Guo Y, He S, Gu T et al., Genetic and clinical risk factors of root resorption associated with orthodontic treatment // American Journal of orthodontics and Dentofacial Orthopedics, 2016; 150(2): 283-289

9. Hartsfield JKJr, Pathways In External Apical Root Resorption Associated With Orthodontia // Orthodontics & Craniofacial Research, 2009; 12(3): 236-242

10. Janssens A, Horner K, Rushton VE, et al., Radiation Protection No. 172, Cone beam CT for dental and maxillofacial radiology (Evidence-based guidelines) // https://ec.europa.eu/energy/sites/ener/files/documents/172.pdf (sk. 18.11.2016.)

11. Krieger E, Drechsler T, Schmidtmann I, et al., Apical Root Resorption During Orthodontic Treatment With Aligners? A Retrospective Radiometric Study // Head & Face Medicine, 2013; 9(1): 1-8

12. Patel N, Currier GF, Kadioglu O, et al., A CBCT Comparison Of Anterior Root Resorption In Suresmile And Conventional Edgewise Treatments // Orthodontics: The Art & Practice Of Dentofacial Enhancement, 2012; 13(1): 100-109

13. Patterson BM, Dalci O, Papadopoulu AK, Madakuri S, Mahon J, Petocz P, Spahr A, Darendeliler MA, Effect of piezocision on root resorption associated with orthodontic force: A microcomputed tomogtaphy study // American Journal of Orthodontics and Dentofacial Orthopedics, 2017; 151:53-62

14. Picanço GV, de Freitas KMS, Cancado RH, et al., Predisposing Factors To Severe External Root Resorption Associated To Orthodontic Treatment // Dental Press Journal Of Orthodontics, 2013; 18(1): 110-120

15. Sameshima GT, Sinclair PM, Predicting and preventing root resorption: Part II. Treatment factors // American Journal of Orthodontics and Dentofacial Orthopedics, 2001; 119(5): 511-515

16. Sameshima GT, Sinclair PM, Predicting and preventing root resorption: Part I. Diagnostic factors // American Journal of Orthodontics and Dentofacial Orthopedics, 2001; 119(5): 505-510

17. Savoldi F, Bonetti S, Dalessandri D, et al., Incisal Apical Root Resorption Evaluation After Low-Friction Orthodontic Treatment Using Two-Dimensional Radiographic Imaging And Trigonometric Correction // Journal Of Clinical & Diagnostic Research, 2015; 9(11):70-74

18. Sawicka M, Bedini R, Wierzbicki PM, Vornelis PH, Interrupted Orthodontic Force Results In Less Root Resorption Than Continuous Force In Human Premolars As Measured By Microcomputed Tomography // Folia Histochemica Et Cytobiologica, 2014; 52(4): 289-296

19. Teibe U, Bioloǵiskā statistika. – Rīga: LU Akadēmiskais apgāds, 2007. – 88. lpp.

20. Vedtofte P, Nattestad A. Pulp sensibility and pulp necrosis after Le Fort I osteotomy // New York Journal of craniomaxillofacial surgery 17. 1989. Pp. 167-171

Acta Chirurgica Latviensis

The Journal of Riga Stradins University; Latvian Association of Surgeons; Latvian Association of Paediatric Surgeons

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