The Journal
Relationship exists between relapse and parameters of increased root resorption and decreased crestal alveolar bone levels which is explained by two factors :
1 . Teeth experiencing reduced subcrestal periodontal support through root resorption and crestal alveolar bone loss during orthodontic treatment may have a greater disposition toward relapse due to decreased resistance against relapse forces . 2 . Teeth that relapse may undergo additional root resorption or crestal alveolar bone loss during the tooth movement of relapse . 18
Clinical diagnosis aids to root resorption
Radiographs are commonly used as a diagnostic aid for root resorption .
Radiographic detection of apical root shortening requires certain degree of resorption .
It is difficult to develop a standardized technique to compare same teeth at different times .
Tooth movement makes it more difficult to assess exact amount of root loss especially when the tooth is torqued or tipped .
Commonly used radiographs are ineffective in assessing buccal and lingual root resorption .
Several radiographic techniques used include o Periapical Bisecting Angle o Periapical Paralleling o Orthopantomogram o Cephalogram
Radiographic technique that has most favorable benefit to risk ratio in detecting degree of apical root material loss = Periapical Paralleling Technique as it provides most appropriate information with least irradiation to the patient when used for teeth that are most likely to exhibit blunting of roots : Maxillary And Mandibular Incisors .
Periapical technique provides less distortion and superimposition errors compared with OPG .
Modern imaging technologies - Computed tomography ( CT ), currently used strictly for research .
Advantage over conventional radiographs as a diagnostic tool is significant .
CT is a costly procedure and demands special equipment . 9,20
Clinical Considerations
Patient or Parents must be informed that apical root shortening may be a consequence of orthodontic treatment . Its incidence is highly unpredictable .
Periapical radiographs
It play an important part of complete orthodontic records . It is useful to compare pretreatment and post-treatment root resorption .
If it is impossible to predict the onset of root resorption , periodic radiographs are indicated . Periapical radiographs of the incisors should be taken at least every year after appliance placement .
Post-treatment radiographs - To assess the bone / root integrity , of which the patient must be informed . 9
Orthodontic Treatment Timing
Orthodontic treatment should begin as early as possible .
There is less root resorption in developing roots .
Young patients show better muscular adaptation to occlusal changes .
Adults have poorer adaptive ability and need more rigid and longer lasting mechanical forces .
The orthodontic force should be Intermittent and Light . 15
When root resorption is detected during active treatment , final goals must be
47 Vol . 14 No . 1 Jan-Apr 2018