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Objective: To evaluate the long-term status of incisors with canine-induced root resorption (CIRR)., Materials and Methods: Subjects with impacted maxillary canines (IMC) and persisting incisors with CIRR examined with cone beam computed tomography (CBCT), diagnosed ≥ 5 years earlier, were recalled. The resorption grade in the horizontal and vertical plane was assessed on CBCT images at baseline (T0) and follow-up (T1). Clinical examination was done at T1 which included probing depth, gingival retraction, mobility, ankylosis, discoloration and vitality test. In addition, patients completed a questionnaire regarding symptoms from the incisors., Results: Forty subjects (mean age 13.7 ± 2.1 years) with 43 IMC and 47 incisors with CIRR were recruited. The IMC either spontaneously erupted, were surgically exposed or surgically removed. Thirty-four of the patients were treated with a fixed appliance and six had no orthodontic treatment. The follow-up range was 5.5-14.6 years. None of the incisors were lost or endodontically treated at T1. The horizontal resorption grade was unchanged in 38, improved in 7, and worsened in 2 teeth. The corresponding results for the vertical resorption grade were unchanged in 20 and worsened in 27 teeth. Three incisors with severe horizontal resorption at T0 were significantly more obliterated at T1 (P = .01). No significant differences were found in clinical parameters or patient-reported outcomes between incisors with CIRR and non-resorbed contralateral incisors at T1., Limitations: The extent of root resorption during active orthodontic treatment was not possible to assess as only CBCT images from T0 and T1 were available., Conclusion: Incisors with CIRR caused by IMC have a high survival rate in a long-term perspective and do not cause more symptoms or exhibit more signs of pathology than non-resorbed contralateral incisors. Extraction of asymptomatic incisors based solely on root resorption should not be performed routinely., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Orthodontic Society.)

Objectives: To examine dentoalveolar changes following intrusion of maxillary incisors with one or two anterior miniscrews in subjects with gummy smile and deep bite., Materials and Methods: Forty-three subjects were selected and divided into two groups: group I (22 subjects: 15 women, 7 men; mean age 30 ± 10 years) received one miniscrew between the upper central incisors, and group II (21 subjects: 16 women, 5 men; mean age 30 ± 10 years) received two miniscrews between the canines and lateral incisors. Dentoalveolar parameters, including amount of intrusion, root resorption, incisor inclination, alveolar bone thickness, and buccal alveolar crest height (cementoenamel junction to labial alveolar crest), were evaluated using cone-beam computed tomography scans obtained before and after intrusion. The intergroup comparison was analyzed using a paired t-test and unpaired t-test to determine significant changes within and between groups., Results: The amount of intrusion was significantly greater in group II than in group I (P < .05). No statistically significant differences were found between groups I and II for changes in incisor inclination, labial bone thickness, and buccal alveolar crest height (P > .05)., Conclusions: Maxillary central and lateral incisor intrusion was significantly greater in subjects treated with two miniscrews. Root resorption of the maxillary central incisors was notably greater in subjects with one miniscrew, while maxillary lateral incisor resorption was greater in subjects treated with two miniscrews., (© 2024 by The EH Angle Education and Research Foundation, Inc.)

Background: The maxillary permanent canine is one of the most frequently impacted teeth, which often requires multidisciplinary management. A common complication of canine impaction is root resorption of the adjacent dentition. The aim of this retrospective study was to report the prevalence of root resorption of maxillary incisors adjacent to impacted maxillary canines from small volume CBCT images by trained clinicians. A secondary objective was to report the location and severity of root resorption., Material and Methods: CBCT images of patients with impacted maxillary canines (unilateral and bilateral) who attended a joint orthodontic/surgical multidisciplinary clinic were screened. Descriptive statistics were used to investigate associations of patient characteristics and presence of root resorption. Generalized estimating equations (GEE) logistic regression model were used to identify predictors of root resorption., Results: In all, 148 impacted maxillary canines (122 patients) were analysed. The majority of patients were under 18 years of age (71.6%) with impacted canines present in more females (68.2%) than males (31.8%). Maxillary lateral incisors showed the highest prevalence of root resorption (38.5%). The apical region was the most common location of resorption for lateral incisors (20.9%) with a variable degree of severity evident: slight (10.1%), moderate (15.6%), and severe (12.8%). Although no significant predictors of root resorption were identified, a weak association was evident for age and root development., Conclusions: In this cohort of patients, the roots of maxillary lateral incisors are most likely to suffer from root resorption in the presence of an impacted maxillary canine. Clinicians should consider the extent, location and severity of resorption of adjacent teeth when planning treatment decisions and mechanics in cases of impacted maxillary canines., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little published literature.A 25-year-old woman was referred to a specialist centre by her general dental practitioner following an incidental finding of a radiographic radiolucency, suggestive of root resorption associated with tooth 21. A provisional diagnosis of external cervical resorption was made, and following cone beam computed tomography (CBCT), a definitive diagnosis of internal tunnelling root resorption given. Non-surgical endodontic treatment was completed using continuous wave compaction with a calcium-silicate based sealer. No further intervention has been required.A summary of the histology, aetiology, prevalence, diagnosis, management and prognosis of internal tunnelling root resorption is provided. The benefits of CBCT for diagnosing and managing internal tunnelling resorption defects and using continuous wave compaction with a calcium-silicate based sealer, compared to cold obturation techniques, are discussed., (© 2024. The Author(s).)

Introduction: With an increasing number of anterior traumatized teeth treated with regenerative endodontic procedures (REPs) nowadays, orthodontic movement of such teeth is expected to become a common scenario in everyday clinical practice. However, little is known about the clinical implications and the response capacity of regenerated tissues to orthodontic forces., Methods: The aim of this clinical article was to report on 4 cases of REP-treated immature anterior permanent teeth subjected to orthodontic forces, and to describe the long-term response of the regenerated apical and intracanal tissues., Results: Signs of orthodontic-induced external root resorption were observed in 2 of the 4 presented cases without, however, the presence of any associated adverse events. No other complications were observed, either clinically or radiographically, throughout the observation period. In the long-term, all 4 cases responded favorably to orthodontic forces, maintaining healthy apical tissues and structural integrity of both intracanal as well as apically regenerated tissues., Conclusions: The orthodontic movement of REP-treated teeth seems feasible, nevertheless, special care should be implemented. Lightly acting orthodontic forces, short duration of active movement, and close monitoring of the patient seem to be prerequisites to limit complications to a minimum and achieve a favorable healing of REP-treated teeth in the long-term following orthodontic treatment completion., (Copyright © 2023 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objectives: To compare changes in root length of maxillary incisors with and without dental trauma throughout orthodontic treatment., Materials and Method: Patients younger than 18 years, with trauma on at least one maxillary incisor, undergoing orthodontic treatment between 2017 and 2021 were included, using the contralateral side as control without trauma when available. Periapical radiographs were taken pre-treatment and at 6 months intervals, and root/crown ratio was calculated. Linear mixed models were used to describe the evolution of root length at the different time points and to compare trauma and control values. Differences between central and lateral incisors and between treatment modalities were additionally explored., Results: A total of 1768 measurements were performed on 499 teeth (201 with trauma) in 135 patients. Incisor root length significantly decreased during orthodontic treatment in teeth with and without trauma. Lateral incisors with trauma were more susceptible to root resorption than those without trauma and central incisors. No significant decrease in root length was observed with removable appliances, which never exceeded 15 months of treatment. Treatment with fixed appliances led to gradually increasing, significant root length shortening in teeth with and without trauma., Conclusion: Treatment duration directly correlated with root length shortening both in teeth with and without trauma history. Teeth with trauma showed significantly more root resorption after treatment with fixed appliances while removable appliances had no significant influence on root length., Clinical Relevance: Previous history of dental trauma is no absolute contra-indication to start orthodontic treatment, as long as treatment duration is kept as short as possible., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To examine the diagnostic value of orthopantomograms (OPG) in the identification of root resorption of lateral incisors, secondary to an impacted canine, as confirmed by a cone-beam computed tomography (CBCT) scan., Design: Retrospective observational cohort study., Setting: South Wales secondary care setting: Royal Gwent Hospital, Newport and Nevill Hall Hospital, Abergavenny., Methods: A total of 40 consecutive patients with impacted canines between January 2018 and December 2019 were selected. For each patient, one consultant orthodontist examined the OPG in isolation to detect the presence and extent of resorption of lateral incisors. The CBCT report was then studied to confirm the presence and extent of pathology. Sensitivity, specificity, accuracy, positive predictive values and negative predictive values were calculated., Results: In total, 19 maxillary right canines, 18 maxillary left canines, one mandibular right canine and two mandibular left canines were examined. Impactions were more prevalent in the maxilla (92.5%) with higher predilection towards female patients (65%). There was higher prevalence of root resorption in the maxillary right quadrant (57.1%), in concordance with other studies. OPGs were found to have a sensitivity of 81.0% and a specificity of 10.5%, with an accuracy value of 47.5%. Positive and negative predictive values were found to be 50.0% and 33.3%, respectively. The extent of root resorption was incorrectly estimated from the OPG in 84% of cases. Correct estimation occurred in 16% of cases, with overestimation and underestimation occurring in equal proportion (42%)., Conclusion: This study demonstrates the limitations of plain film radiographs and the merits of using CBCT in the accurate diagnosis of resorption of lateral incisors with an associated impacted canine. It also gives an indication into the location prevalence of resorption in a small cohort of patients. This preliminary study establishes the basis for future, larger-scale studies where outcomes can be generalisable at a population level.

Introduction: The objectives were to evaluate the morphologic changes of the incisive canal (IC) and the influence of IC proximity to apical root resorption of maxillary central incisors after anterior tooth movement., Methods: Pretreatment and posttreatment cone-beam computed tomography images of adults (aged 18-47 years) were retrospectively evaluated. Subjects were divided into control group with minimal incisor movement (n = 32; maxillary incisor tip movement <2 mm) and maximum retraction group (n = 35; maxillary incisor tip movement >4 mm). The shape, direction, morphologic changes of the IC, the proximity of the central incisor root to IC, and the amount of apical root resorption associated with the proximity after orthodontic treatment were compared., Results: Changes in the shape of the IC were not observed in both control and retraction groups. However, 11.4% (4 of 35 subjects) in the retraction group indicated changes in the direction of the IC from slanted-straight to slanted-curved type after the direction of anterior retraction. The thickness of the cortical bone surrounding the IC and the distance between the incisor root and IC significantly decreased after orthodontic treatment in both groups (P <0.05). However, these changes were significantly greater in the retraction group than in control (P <0.0001). Contact or invasion of the incisor root to the IC was more prominent in the retraction group (42.8%-54.3%) than the control (10.9%-12.5%) (P <0.0001). The amount of root resorption indicated a tendency to increase in the order of separation, approximation, contact, and invasion in relation to IC., Conclusions: Although remodeling of IC was evident in some patients, contact or invasion of the maxillary central incisor roots to IC was fairly high after maximum anterior retraction., (Copyright © 2021 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The objective of this study was to investigate the effects of dehiscence and fenestration on external apical root resorption (EARR) in maxillary incisors., Methods: Seventy-eight patients were selected for this study. We set dehiscence, fenestration, sex, extraction, or nonextraction, tooth position, initial age, and duration of treatment as independent variables and EARR as the dependent variable. General statistical descriptions for these variables were made by mean, standard deviation and occurrence rates, etc. To make the data visualization and find more information, 2 heat maps were made. Generalized estimation equation analysis was performed to determine associations between EARR and independent variables., Results: The occurrence rates of dehiscence and fenestration in maxillary incisors were 14.77% and 10.74%, respectively. The average value of EARR was 1.09 ± 0.87 mm in this study. Dehiscence, tooth position, extraction, initial age, and duration had significant correlations with EARR. The ratio of exponent B was 1:1.643 for dehiscence and nondehiscence, whereas fenestration and sex had no significant association with EARR., Conclusions: The amount of EARR at maxillary incisors in patients with dehiscence before orthodontic treatment might be less than that in patients without it, and different incisors might have different contributions to it. However, the low value of exponent B for dehiscence meant that there might be other unknown factors that were involved in this study., (Copyright © 2021 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: Invasive cervical resorption (ICR) is a relatively rare type of ERR (External Root Resorption), in which a localized resorption begins in the cervical area of the tooth, below the epithelial junction and above the ridge crest., Objective: Describe the clinical case of an 11-year-old boy with no dental trauma history, presenting moderate crowding and ectopic eruption of the maxillary right central incisor. He had been undergoing orthodontic treatment elsewhere, and his family was dissatisfied with the results., Description: A new treatment was indicated, which included rapid maxillary expansion followed by extraction of four premolars. During routine panoramic evaluation, a radiolucid image was detected and a periapical radiograph was requested. At this point, an ICR of the maxillary right central incisor was found. The treatment was cautiously finalized and despite the use of light forces, central incisor was severally compromised by ICR and was therefore extracted., Conclusion: This clinical example discusses the importance of routine radiographs for the early diagnoses of ICR.

Objectives:: To determine upper incisor root resorption, volume loss, and the relationship between root volume loss and tooth movement after 1 year of orthodontic treatment in patients with marginal bone loss., Materials and Methods:: A total of 30 women (46.3 ± 5.4 years old) with moderate upper incisor bone loss who required intrusion during orthodontic treatment were recruited. Pre- and post-treatment cone beam computed tomography images were reconstructed. Upper incisors at pre- and post-treatment were superimposed; labio- and palato-apical, middle, and coronal third root volumes were assessed. Tooth movement and alveolar bone height were measured from lateral cephalometric radiographs and cone beam computed tomography. Changes in root volume/alveolar bone height were compared using paired-sample t-tests, percentage root volume loss for each tooth/segment was evaluated by one-way analysis of variance, and the relationship between percentage root loss and degree of tooth movement was assessed by linear regression., Results:: Mean root volume significantly decreased on the labio- and palato-apical aspects of 12 and labio-apical aspects of 21 and 22 ( P ≤ .024). Palato-apical segment volume loss was greater on lateral than central incisors ( P ≤ .016). Two-dimensional root length and cementoenamel junction-bone crest distance did not change between T0 and T1, with no significant relationship between tooth movement amount and percentage root volume loss., Conclusions:: Delivery of 40 g intrusive force to the four upper incisors using a T-loop and the leveling phase lead to more apical root volume loss on lateral than central incisors. There was no relationship between extent of tooth movement and upper incisor root volume loss.

Background/objectives: The aims were 1. to analyse differences in the occurrence of orthodontic induced inflammatory root resorption (OIIRR) of the upper and lower incisors in Angle Class II division 2 patients, between patients treated with fixed appliance only (one-phase treatment group) and patients treated with removable appliance before treatment with fixed appliance (two-phase treatment group) and 2. to analyse differences in OIIRR between treatment time, age, gender, craniofacial morphology and deviations in the dentition for the two groups together., Materials/methods: Seventy-four subjects treated for Class II division 2 malocclusion were divided into two groups: 46 patients in the one-phase treatment group (28 girls, 18 boys, mean age 14.4) and 28 patients in the two-phase treatment group (18 girls, 10 boys, mean age 12.4) where 336 and 201 incisors were analysed respectively. OIIRR was assessed on intra oral radiographs, deviations of the dentition were assessed on orthopantomograms and the craniofacial morphology was assessed on lateral cephalograms. Differences were tested by Fisher Exact test, McNemar, and multiple regression analysis., Results: The one-phase treatment group showed significantly more OIIRR for lower central incisors (P = 0.002) compared to the two-phase treatment group. For the both groups combined, boys showed more OIIRR than girls (P = 0.002) and patients with agenesis showed more OIIRR than patients without agenesis (P = 0.019) for the lower central incisors., Conclusion: The results indicate that two-phase treatment modalities may be considered as an option for Angle Class II division 2 patients with enhanced risk for OIIRR.

Introduction: Intrusive luxation is one of the most severe traumatic injuries of permanent teeth that may adversely affect the pulp and the periodontium. Pulp necrosis and root resorption are the main pathologic entities associated with this injury. The present report describes the endodontic management of an intruded immature maxillary central incisor presented with pulp necrosis and severe inflammatory root resorption by using the regenerative approach., Methods: A 7-year-old boy with dental trauma to the anterior maxillary region was referred for the management of a traumatized maxillary central incisor. Clinical examination revealed an uncomplicated crown fracture, whereas radiographic examination showed that the tooth was immature, confirming the intrusion that was calculated between 3 and 4 mm. The tooth was left to re-erupt, but after 2 months the boy presented with intraoral swelling. Radiographic examination showed initial signs of root resorption. The tooth was treated by using a regenerative endodontic approach., Results: Clinical and radiographic examinations during the initial follow-up period showed resolution of the signs and symptoms as well as inhibition of the resorption process. At the follow-up examinations, the tooth remained free of signs and symptoms and completely functional. The radiographic recall examinations showed a gradual thickening of the root canal walls but incomplete apical closure., Conclusions: The present case shows that severely injured teeth with uncertain prognosis may have a considerable percentage of chance to remain functional and free of signs and symptoms by using a regenerative endodontic procedure, confirming the efficacy of this procedure as a viable treatment option., (Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

The aim of this case report is to describe the treatment of an 11-year-old boy who was referred to an endodontist for evaluation of external inflammatory root resorption in the distal apical third of the permanent maxillary left lateral incisor, caused by deviation in the eruption path of the permanent maxillary left canine. The results of the pulpal sensitivity test of the permanent maxillary left lateral incisor were inconclusive and similar to those for the homologous tooth, so the endodontist opted for a clinical and radiographic follow-up. The patient was referred to an orthodontist, who placed a fixed Haas-type palatal expander. After the eruption of all permanent teeth, the orthodontist placed a fixed orthodontic appliance. After approximately 3 years of monitoring, bone repair with dental remodeling was observed, and the results of a pulpal sensitivity test were positive. This case demonstrates that proper monitoring is critical in establishing the diagnosis and treatment plan and ultimately to the success of clinical management.

Objective: Canine impaction is a dental anomaly involving intraosseous displacement of the unerupted tooth. This situation is of significant importance causing orthodontic, surgical and interceptive problems. Trauma in the incisor area is a possible cause of the displacement of the tooth bud of the permanent canine resulting in the deviated eruption path. The aim of this article is to present two clinical cases with diagnosis of maxillary canine displacement and impaction in the incisor region after a traumatic injury during childhood, discussing treatment possibilities and outcomes achieved after orthodontic treatment., Materials and Methods: In this article ectopic maxillary canines migration in the central incisor area after a traumatic injury to the anterior upper teeth are described. The path of eruption of the canine can cause severe central incisor root resorption. Treatment strategy established for the case reports described involves orthodontic space opening, extraction of the central incisor, uncovering the impacted canine and orthodontic traction of the tooth in place of central incisor. Modification of crown morphology and color were essential to obtain an aesthetic and function outcome., Results: The patients finished treatment with normal and stable occlusion, an adequate width of attached gingiva and good aesthetic results., Conclusion: Authors suggest that might have been a possible connection between the trauma of primary dentition causing the displacement of the tooth bud of permanent canine and the deviated path of eruption. For the growing patients with a combination of dental trauma and ectopic eruption, maxillary canine to replace a central incisor was a viable option, offering excellent aesthetic results without recourse to prosthetic replacement.

Objective: To analyze and compare external apical root resorption (EARR) of maxillary incisors treated by intrusion arch or continuous archwire mechanics., Materials and Methods: This cone-beam computed tomography (CBCT) study analyzed 28 deep bite patients in the permanent dentition who were randomly divided into two groups: Group 1, 12 patients with initial mean age of 15.1 ± 1.6 years and mean overbite of 4.6 ± 1.2 mm treated with the Connecticut intrusion arch (CIA) in the upper arch (Ortho Organizers, Carlsbad, Calif) for a mean period of 5.8 ± 1.27 months. Group 2, 16 patients with initial mean age of 22.1 ± 5.7 years and mean overbite of 4.1 ± 1.1 mm treated with conventional leveling and alignment using continuous archwire mechanics for 6.1 ± 0.81 months. The degree of EARR was detected in 112 maxillary incisors by using CBCT scans and a three-dimensional program (Dolphin 11.7, Dolphin Imaging & Management Solutions, Chatsworth, Calif). The CBCT scans were obtained before (T1) and 6 months after initiation of treatment (T2). Differences between and within groups were assessed by nonpaired and paired t-tests, respectively, with a 5% significance level., Results: Significant differences were found for both groups between T1 and T2 ( P < .05) indicating that EARR occurred in both groups. However, there were no significant differences when EARR was compared between group 1 (-0.76 mm) and group 2 (-0.59 mm)., Conclusions: The Connecticut intrusion arch did not lead to greater EARR of maxillary incisors when compared with conventional orthodontic mechanics.

Resorption is both a physiological and pathological process which results in loss of hard tissues of the tooth, i.e , cementum and dentine and the surrounding bone. External resorption is much more common than internal resorption and can occur when tooth is luxated or avulsed. If remained unchecked, resorption can eventually lead to loss of the tooth. Timely management of the affected tooth can slow down the resorptive lesion and increase the prognosis of the survival of the tooth. This case report describes the surgical management of extensive external root resorption leading to perforation of apical one-third of the root area which was managed through root canal along with periapical surgery and bone grafting. A 6-month follow-up showed arrest of the resorptive defect and progressive healing as evident on the cone-beam computed tomography., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

The aim of this study was to evaluate the accuracy of bone sounding (BS) in assessing the facial osseous-gingival tissue relationship (FOGTR) of failing maxillary anterior teeth. Dental records of patients who received immediate implant placement (IIP) at the maxillary anterior area were screened. Mid-FOGTR prior to extraction (BS), and immediately after flapless extraction (direct bone level [DBL] measurement) were analyzed. A total of 160 patients with 190 maxillary anterior teeth were included. The mean FOGTR obtained from BS and DBL were 3.19 ± 0.71 mm and 3.47 ± 1.29 mm, respectively (P = .004). The two measurements were identical 83.2% of the time, within 1-mm discrepancy 4.7% of the time, and > ± 1 mm discrepancy 12.1% of the time. When discrepancy was observed, BS underestimated DBL 14.2% of the time and overestimated 2.6% of the time. Though statistically significant, the correlation was weak (Pearson correlation coefficient r = .238, P = .0018). BS is an acceptably accurate and minimally invasive diagnostic tool for measuring FOGTR. However, while the mean difference between BS and DBL measurement is small (0.28 mm), the large range of difference can be alarming. Therefore, clinicians should always prepare alternative treatment options for IIP prior to extraction.

Objectives: The aim of this study was to analyze the amount of root resorption of maxillary lateral incisors by relating the position, location, and angulation of the impacted canine using cone-beam computed tomography (CBCT)., Materials and Methods: The study sample consisted of panoramic and CBCT radiographs of 46 patients with a unilateral impacted canine (16 males and 30 females; mean age: 19.53 ± 6.66 and 19.44 ± 5.77 years, respectively). Sector location and canine angulation were measured in panoramics. All tomographs were obtained using CBCT (NewTom 5G, QR, Verona, Italy) and three-dimensional (3D) reconstructions of the maxillary laterals assessed by Mimics 14.01 image analysis software., Results: Upper lateral incisor volume was smaller on the impacted side (401.95 ± 83.69 mm 3 ) than on the nonimpacted side (433.54 ± 92.6 mm 3 , P < 0.05). There were no significant differences of lateral root resorption volume when comparing the impacted canines being on the labial or palatal sides (P > 0.05), but impacted canine angulation was significantly steeper on the labial side (70.85°) than on the palatal side (46.09°, P < 0.05). The volume of root resorption of laterals when comparing the various positions of the canine in different sectors or canine angulation in 30 o intervals was not statistically significantly different (P > 0.05)., Conclusions: The impacted canines caused root resorption of lateral incisors. The angulation of the canine was steeper on the labial side than on the palatal side but root resorption of adjacent laterals was not different. There were no statistically significant differences in the amount of root resorption of the laterals when the canine was evaluated according to localization and angulation.

Objective: Tooth transposition is a rare dental anomaly that could lead to undesirable side effects on other teeth. This case report aims to describe the multidisciplinary treatment of a patient with a severely resorbed permanent maxillary central incisor due to transposition with the permanent canine., Clinical Considerations: A girl aged 13 years and 7 months with a chief complaint of a pink spot on her maxillary left incisor with a slightly erupted tooth above it was referred to our clinic. Her left maxillary canine was transposed to her left central incisor site. The left canine was impacted and had caused severe resorption of the left central incisor root. Her maxillary left canine was substituted for the central incisor after the compulsory extraction of her left central incisor. The canine was prosthetically restored after orthodontic treatment. The results were stable 1 year after treatment had been completed., Conclusions: Orthodontic treatment in coordination with other dental specialties like prosthodontics, periodontology and oral and maxillofacial surgery can provide functional and esthetic outcome in cases of severely transposed canines., Clinical Significance: This is a rare case of transposition that shows the significant root resorption on the maxillary central incisor due to the ectopic eruption of the canine. Canine substitution for the central incisor was chosen as a treatment plan instead of placing an implant. An esthetic smile and a functional occlusion were established at the end of the treatment. (J Esthet Restor Dent 29:5-12, 2017)., (© 2016 Wiley Periodicals, Inc.)

Background: The boundaries for orthodontic tooth movement are set by the bony support of the dentition. This study compares the mandibular anterior alveolar housing in individuals with low, average, and high mandibular plane angles before orthodontic treatment and measures alveolar bone loss and root resorption after orthodontic treatment., Methods: Pretreatment cone-beam computed tomography (CBCT) images of 75 non-growing individuals, 25 in three groups: low-angle (sella-nasion to mandibular plane ≤28°), average-angle (30°-37°), and high-angle (≥39°), were analyzed. Buccolingual bone thickness was measured at the root apex, mid-root, and alveolar crest of the mandibular right central incisor. Pre- and posttreatment CBCT images of 11 low-angle, 20 average-angle, and 27 high-angle patients were compared to determine changes in the alveolus and mandibular incisor root after orthodontic treatment., Results: The pretreatment anterior alveolar bone widths were significantly different, wider in low-angle than in average- and high-angle individuals (p value = 0.000). High-angle individuals also had greater posttreatment external root resorption, even though the bony housing changed minimally., Conclusions: Negative sequelae of orthodontic treatment are more frequently found in individuals with high mandibular plane angles and could be linked to their thin pre-existing alveolar housing.

Many studies have focused on the search for a restorative material with good sealing properties and biocompatibility for treatment of teeth with open apices and necrotic pulps, which can result from periradicular disease and root resorption. Mineral trioxide aggregate (MTA) has exhibited promising clinical results in retrograde fillings and pulpotomies as well as for treatment of root perforations, root resorptions, incomplete root formations, and pulpal necrosis. This case report describes the management of a progressive apical root resorption in a previously traumatized tooth that had been endodontically treated. Five years of clinical and radiographic follow-up demonstrated the clinical efficacy of MTA in limiting the inflammatory resorptive process and promoting apexification and regeneration of periradicular tissue.

Root resorption of the permanent teeth involves an elaborate interaction among inflammatory cells resulting in loss of dental hard tissues. This report describes three clinical cases where idiopathic root resorption occurred in wind instrument playing patients. These patients produce adequate non-orthodontic forces, while playing their instruments, to expose their teeth to root resorbing force. Careful clinical monitoring of patients' teeth should be undertaken, as the additive effects of orthodontic treatment and musical habits are unknown. CPD/Clinical Relevance: This paper advises that questioning about wind instrument playing during case history-taking would be beneficial to clinicians. Furthermore, careful clinical monitoring of these patients' teeth during orthodontic treatment should be undertaken.

Introduction: Our objective was to measure the impact on perceived root resorption based on the amount of anteroposterior incisal inclination as determined in vitro from conventional panoramic radiography., Methods: A rapid prototyping model was created to mimic different maxillary and mandibular incisal anteroposterior inclinations. Two titanium beads were placed on the incisors at the apical and incisal edges. Panoramic radiographs were obtained, with the incisors changing relative inclination by 10° increments. The length was measured from the midpoint of the bead on the incisal edge to the midpoint of the bead on the apical edge. By using a length of wire of known size, this value was compared in all images to correct for image magnification., Results: Changes to mandibular incisor anteroposterior inclinations, as either a theoretical proclination or retroclination, resulted in an increase of "apparent" root resorption on a panoramic radiograph. When the maxillary incisors were significantly and severely retroclined, they appeared larger than expected. When the maxillary incisors were mildly retroclined, the length was roughly similar to the theoretical model. When the maxillary incisors were mildly proclined, they appeared shorter than expected., Conclusions: The foreshortening or forelengthening of incisor root lengths because of incisor inclination vs root resorption cannot be reliably evaluated from panoramic images. The proposed theoretical model helps to understand the direction of the changes produced by the magnification factor. More severe scenarios where either the maxillary or the mandibular teeth are outside the focal trough have not been fully evaluated. The clinical impact of these changes is likely to be questionable., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

The incisive canal is located on the median plane of the maxilla, posterior to the roots of the central incisor. Although the incisive canal is not considered an anatomic structure that may limit tooth movement, it has recently gained attention regarding the possibilities of surgical invasion and associated complications because of its proximity to the maxillary central incisors. In the 2 illustrated cases, lip protrusion was improved by en-masse bodily retraction of the anterior teeth (>8 mm) using temporary anchorage devices. Three-dimensional cone-beam computed tomography showed that the maxillary incisor roots were approximated to the incisive canal after maximum retraction. One central incisor root was in direct contact with the incisive canal with severe root resorption, but tooth vitality and the overall occlusion were stable in the long term without any sensory dysfunction. The apparent root resorption may be mainly related to the large amounts of anterior retraction and root movement in the 2 patients. However, the anatomic location of the incisive canal and the possibilities of its invasion after tooth movement should be closely monitored when maximum retraction is planned, to prevent potential complications., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Invasive cervical root resorption is an uncommon external root resorption which initiates at the cervical aspect of the tooth. This case report involves a case of cervical root resorption which was initially misdiagnosed and managed as cervical root caries. It was later diagnosed with cone beam CT and the lesion microsurgically removed and restored with resin modified glass ionomer cement. The importance of increasing awareness of this uncommon pathology and the role of cone beam CT in mapping the extent of the lesion is emphasised., (2015 BMJ Publishing Group Ltd.)

Aims: This study aimed to determine the kinds of sequelae resulting from intrusive luxation and subluxative injuries in primary anterior teeth as well as the timing of such sequelae., Materials and Methods: In this longitudinal retrospective study, data were collected from dental records and radiographs of patients with traumatic dental injury (TDI) treated at the Centre for the Study and Treatment of Dental Trauma in Primary Dentition (Pelotas, RS, Brazil). Fifty-two children, with seventy intruded teeth, and 76 children, with 99 subluxated teeth, met the inclusion criteria. Sequelae, such as crown discoloration, fistula, pulp canal obliteration (PCO), inflammatory root resorption (IRR), and internal root resorption, were investigated. The data on the sequelae were distributed into eight follow-up periods: 0-30 days, 31-90 days, 91-180 days, 181-365 days, 1-2 years, 2-3 years, 3-4 years, and >4 years., Results: The sample comprised 99 subluxation cases and 70 intruded teeth. Crown discoloration was the most prevalent sequelae. Among the subluxated teeth, <50% of IRR, fistula, crown discoloration, and PCO occurred within 180 days after TDI; however, the sequelae were also diagnosed after longer periods. Majority of sequelae of intrusion were diagnosed within the 181-365 days and 1-2 years periods but were also observed after more than 4 years of follow up., Conclusions: For both intrusion and subluxation, trauma sequelae were diagnosed even after the 3-4 years of follow-up., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Severe incisor root resorption (SIRR) associated with impacted maxillary canines is rare but has important implications. Early diagnosis and treatment are imperative. In this investigation, we aimed to identify predisposing factors for impacted canine-linked SIRR., Methods: Clinical and radiographic data of 55 consecutive patients (77 canines) with SIRR of 96 incisors were compared with data from 57 consecutive control subjects (72 canines). The studied variables were age, sex, position of the impacted canine, size of the dental follicle, and incidence of anomalous lateral incisors., Results: Lateral incisors were more often affected than central incisors, and bilateral SIRR was common. When each variable was examined separately, SIRR was significantly associated with female sex, severely mesiodistally displaced and vertically positioned canines in the middle third of the adjacent incisor root, dental follicles wider than 2 mm, and normal lateral incisors. The multivariate statistical analysis showed that the risk for SIRR was significantly higher in female subjects (4.2 times) with enlarged dental follicles (8.3 times) and normal lateral incisors (5.8 times)., Conclusions: SIRR should be carefully screened in female patients with enlarged dental follicles and normal lateral incisors. A greater degree of canine displacement might also be associated with SIRR., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

The purpose of this report was to describe the morphological changes in the alveolar bone after delayed replantation of avulsed teeth using three dimensional cone-beam computed tomography in 11 during the time period 2003-2012. The radiographic observations revealed the following: Delayed replantation results in ankylosis-related replacement root resorption; the resorption is delayed or arrested around the cervical area superior to the alveolar crest. The buccal bone is reduced in thickness but not the palatal bone. The buccal bone resorption of the alveolar crest progresses approximately to the root canal space of the ankylosed root. Delayed replantation does not completely maintain the bone volume. The buccal profile of alveolar bone in the maxillary anterior region is depending on teeth with viable periodontal ligament., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Root resorption is a frequent finding in teeth with apical periodontitis. In cases of severe apical periodontitis, root resorption may involve not only cementum but also dentin. Resorbed tooth structures can only be repaired with cementum because stem cells in the periradicular tissues are not capable of differentiating into odontoblasts. This article reports the repair of extensive apical root resorption associated with apical periodontitis 25 years after treatment., Methods: A 51-year-old man presented with pulp necrosis and symptomatic apical periodontitis in tooth #7. The periapical radiograph showed a large radiolucent periradicular lesion and severe root resorption. Nonsurgical root canal therapy was performed. Twenty-five years after treatment, a crown fracture developed, and the tooth could not be restored. The periapical radiograph revealed complete healing of the previous apical periodontitis lesion and restoration of the resorbed root structure. The tooth was removed and examined histologically., Results: The apical canal was almost completely filled with a cementumlike tissue with some strands of entrapped vital uninflamed connective tissue. Areas of cementum and dentin resorption in the apical third were repaired by a combination of cellular and acellular cementum to which periodontal ligament fibers were attached., Conclusions: Root resorption caused by apical periodontitis can be restored almost to its normal structure after adequate nonsurgical root canal treatment that succeeded in controlling infection. The mechanisms behind this process are not clear but probably involve signaling pathways regulating root development, cell-cell and cell-matrix interaction, and morphogens., (Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

This study aims to critically evaluate orthodontically induced external apical root resorption (OIEARR) in incisors of patients undergoing non-surgical orthodontic treatment of class II division 1 malocclusion by a systematic review of the published data. An electronic search of two databases was performed; the bibliographies of relevant articles were also reviewed. Studies were included if they examined the amount of OIEARR in incisors produced during non-surgical orthodontic treatment of individuals with class II division I malocclusion in the permanent dentition. Individuals had no previous history of OIEARR, syndromes, pathologies, or general diseases. Study selections, risk of bias assessment, and data extraction were performed in duplicate. Eight studies of moderate methodological quality were finally included. An increased prevalence (65.6% to 98.1%) and mild to moderate severity of OIEARR (<4 mm and <1/3 original root) were reported. No sex difference in root resorption was found. For the maxillary incisors, there was no evidence that either the central or lateral incisor was more susceptible to OIEARR. A weak to moderate positive correlation between treatment duration and root resorption, and anteroposterior apical displacement and root resorption was found. Current limited evidence suggests that non-surgical comprehensive orthodontic treatment to correct class II division 1 malocclusions causes increased prevalence and severity of OIEARR the more the incisor roots are displaced and the longer this movement takes.

Internal inflammatory root resorption is characterised by progressive destruction of intraradicular dentin and dentinal tubules along the root canal wall. A number of theories have been proposed as a possible cause for internal resorption. It is usually asymptomatic and detected during routine radiographic investigations. Prompt diagnosis and early management of such defects is essential to maintain the integrity of the tooth. Non-surgical and surgical methods are the two main strategies involved in the management of internal resorption. The non-surgical method is usually preferred, but in cases of extensive resorption with external root perforation, surgical intervention has been advocated. The present case illustrates repair of perforating internal resorption by hybrid method, using mineral trioxide aggregate and gutta-percha, following surgical exposure. After a 10-month follow-up, no clinical and radiographic abnormalities were observed. Additionally, there was also marked reduction in periodontal pocket depth.

This is the report of a case of four upper incisors with multiple internal/external resorptions after a falling accident in the childhood and subsequent violation of the biologic width by incorrect individual coronal restorations. Endodontic orthograde retreatment was performed and mineral trioxide aggregate (MTA) was placed as apical plug and to repair the large internal resorption. In order to re-establish the biologic width, a controlled surgical crown-lengthening procedure was performed. The expression of matrix metalloproteinase (MMP)-9 in the gingival tissue was used as a biomarker for the presence of inflammation in the hypertrophied gingiva. The one-year control revealed the cessation of the resorptive activities and the stability of the periodontium. The choice for a conservative combined treatment was essential in maintaining the affected teeth in an esthetically challenging area.

Introduction: The diagnosis of apical root resorption is usually based on routine radiographs. However, these methods are limited because the images reflect the superimposition of the whole root structure and can lead to underestimation of the extent of apical root resorption. In this study, we aimed to determine the lengths of the labial and lingual surfaces of incisors with apical root resorption and compare them with the longest radicular length obtained on sagittal images of cone-beam computed tomography, and to create a qualitative visual scale of the different patterns of apical root resorption., Methods: Eighty-two incisors with apical root resorption from 25 patients had their labial and lingual root surfaces and the longest radicular lengths determined in the sagittal plane and compared. Five orthodontists, at 2 times, classified the images of each incisor according to a visual scale developed by the authors., Results: There was no significant difference between the labial and lingual surfaces; however, the longest radicular length was significantly greater than the shortest surface length. The visual scale showed intraobserver agreement of 0.615 and interobserver agreements of 0.74 and 0.52 at both times, respectively., Conclusions: The difference between the longest and shortest root lengths suggests that radiographic superimposition underestimates the extent of the resorption lesion. The proposed visual scale showed a frequency of agreement above 65% and a coefficient of reproducibility varying from moderate to substantial., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Objectives: The aim of this study was to evaluate the prevalence of root resorption of maxillary incisors caused by impacted maxillary canines using low-dose dental computed tomography and to gain additional knowledge of the underlying aetiology and the progression of root resorption., Materials and Methods: A total of 440 patients (mean age, 24.7 years) with 557 impacted maxillary canines were examined regarding their location and the occurrence of root resorption of maxillary incisors., Results: The frequency of root resorption was 2 % of central and 7.7 % of lateral maxillary incisors. The location of the 557 impacted canines within the dental arch was palatal in 67.5 %, buccal in 15.4 % and central in 17.1 %. No significant differences could be shown with respect to the width and the shape of the dental follicle of the impacted maxillary canines and the presence of root resorption of incisors. The presence of root resorption of central (p < 0.0001) and lateral (p < 0.023) maxillary incisors was significantly correlated with an existing contact relationship of the impacted maxillary canines., Conclusions: Our investigation confirms the theory of prior reports comprising a much larger patient population, hypothesising that the dental follicle of impacted maxillary canines does not cause resorption of adjacent maxillary incisors per se., Clinical Relevance: Root resorption of maxillary incisors is correlated with effects of contact of the impacted maxillary canines, and these findings should be considered in treatment planning. Our findings are consistent with other reports and may develop new treatment approaches for the treatment of this sequela.

Unlabelled: The impaction phenomenon is a pathological condition which is defined as the lack of eruption of a permanent tooth in the oral cavity. After third molar, the first permanent tooth impacted in the alveolar bone is the permanent maxillary canine, with varies from 1% to 3%. The aim of this study was to use the most recently imaging technique--CBCT, to evaluate the position of the impacted maxillary canine and to determinate the severity of root resorption of the adjacent teeth., Material and Methods: The all 230 patients of this study were referred to a CBCT scanning with Scanora machine and only the region of clinical interest was irradiated., Results: The age of the subjects was distributed between the ages of 11 and 42 years. From a total of 364 impacted canine teeth, 92 were side impacted canines, 97 right impacted canines and 87 were left impacted canines., Discussion: We report a lateral incisors root resorption present in 54.37% and 24.29% the resorption of central incisors., Conclusions: The use of CBCT in patients with impacted canines has potential diagnostic and may influence the planning of treatment. Also the CBCT can be a genuine method used to rectify, to diagnose and to make a suggestive treatment for the resorption of the root of incisors.

The aim of this study was to examine the potential relationship between the occurrence of orthodontic root resorption and presence of dental anomalies such as tooth agenesis and pipette-shaped roots. Dental anomalies and root resorption were assessed on dental panoramic tomographs (DPT) of 88 subjects, 27 males and 61 females, mean age 28.4 (SD = 11.3 years), selected from orthodontic patients on the basis of the following exclusion criteria: previous fixed appliance treatment, bad quality of the DPTs and no visibility of the periodontal ligament of every tooth, and younger than 15 years of age at the onset of treatment with fixed edgewise appliance lasting at least 18 months. A pipette-shaped root was identified as defined by a drawing. Tooth agenesis was assessed on DPTs and from subjects' dental history. Root resorption was calculated as the difference between the root length before and after treatment, with and without a correction factor (crown length post-treatment/crown length pre-treatment). If one of the four upper incisors showed root resorption of ≥2.3 mm with both formulas, the patient was scored as having root resorption. Chi-square tests indicated that there was no relationship between orthodontic root resorption and agenesis (P = 0.885) nor between orthodontic root resorption and pipette-shaped roots (P = 0.800). There was no relationship between having one of the anomalies and root resorption either (P = 0.750). In the present study, it was not possible to confirm on DPTs a relationship between orthodontic root resorption and dental anomalies, such as agenesis and pipette-shaped roots.

This study evaluated, over a 4-month study period, the amount of apical root resorption occurring in maxillary central incisors following their retraction when employing either micro-implant or J-hook headgear anchorage. The prospective randomised clinical trial was conducted in Orthodontic Clinic, College of Stomatology, China from 2008-2009. Subjects are patients requiring fixed appliances on waiting list (n=20). In female Han Chinese patients aged from 16-26 years, standardized periapical radiographs from 10 randomly assigned patients with maxillary protrusions comprising the micro-implant group, and from 10 similar patients comprising the J-hook headgear group, were assessed for maxillary central incisor apical root resorption. Measurements before and after orthodontic therapy were also obtained from lateral cephalometric radiographs to calculate incisor horizontal retraction and vertical intrusion distances. Estimated retraction force vectors were calculated in horizontal and vertical directions for both treatment groups. Data analysis employed t-tests and the Pearson correlation test, with α=0.05 for statistical significance. The results showed that when compared with the J-hook group, significantly more apical root resorption shortening of the maxillary central incisors was observed in the micro-implant group (1.27 mm difference, 95% CI=0.70-1.84, P<0.001), which was associated with a significantly larger retraction distance (P=0.004) and a smaller vertical force component (P<0.0001). We are led to conclude that continuous activation of the nickel-titanium coil springs used in the micro-implant group resulted in significantly more apical root resorption shortening and maxillary central incisor retraction than when intermittent J-hook retraction was employed. The employment of continuous duration orthodontic forces presents a risk for increased apical root resorption that requires careful radiographic monitoring.

Purpose: Early diagnosis and treatment of pulp infection in primary incisors are important for preventing systemic infection and damage to the permanent tooth bud. The purpose of this retrospective case-control study was to identify radiographic changes associated with pulp infection in primary incisor roots and their developing permanent dental follicles., Methods: Oblique occlusal radiographs of 102 primary maxillary incisors with sinus tracts were compared to 390 radiographs of incisors from healthy same-age children., Results: Compared with controls, teeth with sinus tracts had more inflammatory root resorption (odds ratio [OR]=50.7, P<.001), pulp pathosis (OR=13.0, P<.001), deep caries (OR=3.9, P<.001), past traumatic injury (OR=3.4, P<.001), enlarged dental sac (OR=10.8, P<.001), loss of lamina dura of the dental sac (OR=27.5, P<.001), and increased radiolucency of the dental sac of the corresponding permanent tooth bud (OR=19.5, P<.001). In multivariate logistic regression, 2 variables were associated with radiographic changes in the primary root (inflammatory resorption, P<.001; and pulp pathosis, P=.004). Two variables associated with changes in the permanent tooth bud (loss of lamina-dura and increased radiolucency) were independently associated with the presence of a sinus tract, P<.001., Conclusion: Deep caries, inflammatory resorption, pulp pathosis, loss of lamina-dura, and increased radiolucency of the dental sac were statistically associated with presence of a sinus tract.

This study evaluated the influence of intrusion mechanics combined with anterior retraction on root resorption of the maxillary incisors. A sample of 56 patients was divided into two groups: group 1 comprised 28 patients (12 females and 16 males), presenting with an increased overjet and deep overbite (6.48 and 4.78 mm, respectively) treated with reverse curve of Spee intrusion mechanics and group 2 comprised 28 patients (12 females and 16 males) with an increased overjet of 5.67 mm and a normal overbite of 1.12 mm. The initial mean ages for groups 1 and 2 were 13.41 and 13.27 years, respectively. Pre- (T1) and post- (T2) treatment periapical radiographs were used to evaluate root resorption. The groups were compared using the Mann-Whitney U-test. Correlation between root resorption and tooth movement was investigated with Spearman's correlation coefficient. The subjects in group 1 had statistically greater root resorption (P < 0.05) than those in group 2. The initial overbite severity and the amount of correction had significant positive correlations with root resorption (r = 0.324 and r = 0.320, respectively). The combination of anterior retraction with intrusive mechanics causes more root resorption than anterior retraction of the maxillary incisors alone.

Introduction: The purpose of the study was to evaluate impacted maxillary canines as risk factor for orthodontic apical root resorption., Methods: The sample comprised 66 patients treated with fixed appliances. Thirty-two patients with a unilateral impacted maxillary canine, which was distanced from the roots of the incisors at a preliminary phase of treatment before bonding, formed the impaction group, and 34 patients without impactions served as the controls. Root shortening was calculated by using pretreatment and posttreatment intraoral radiographs. Inclination of the eruption path of the impacted canine relative to the midline, axis of the lateral incisor, and nasal line, root development, and the medial and vertical positions of the impacted tooth were recorded on orthopantomograms and lateral cephalometric films. The follicle/tooth ratio was evaluated by using periapical radiographs., Results: No significant difference in apical resorption of the maxillary incisors was detected between the impaction and control groups, or between the incisors of the impacted and contralateral sides in the same subject. Likewise, no difference in the severity of root resorption was found between the incisors of impacted side alone and the incisors of the control group. Mesial and vertical inclinations of the impacted canines were negatively related to a lateral incisor's root resorption. No correlations were found between resorption and medial or vertical position of the crown of the canine. The follicle/tooth ratio was significantly related to the mesial inclination of the impacted canine, but not to root resorption., Conclusions: An impacted maxillary canine, after being distanced from the incisor roots, does not seem to be a risk factor for apical root resorption during orthodontic treatment., (Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Purpose: This study was undertaken to compare the clinical and radiographic effectiveness of Mineral Trioxide Aggregate (MTA) and Calcium Hydroxide in apexification of traumatized young permanent incisors., Methods: Thirty permanent incisors with necrotic pulps and open apices were evenly divided into two groups--Group I (MTA group) & Group II (Calcium Hydroxide group) and treated by apexification. The time taken for apical barrier formation was analyzed. In MTA group, obturation using gutta-percha points was done after 24 hours, whereas in Calcium Hydroxide group obturation was carried out after radiographic confirmation of an apical barrier. Follow up evaluation (clinical and radiographic) was carried out at- 3, 6, 9 and 12 months., Results: The mean time taken for barrier in Group I was 4.50 +/- 1.56 months whereas for Group II was 7.93 +/- 2.53 months (p value- 0.0002). Radiographic evidence of mean time taken for completion of lamina dura in Group I was 4.07 +/- 1.49 months whereas the time period for Group II was 6.43 +/- 2.59 months (p value- 0.0067)., Conclusion: MTA demonstrated good success and an effective option for apexification with the advantage of reduced treatment time, good sealing ability, biocompatible and provides barrier for immediate obturation.

Aims: The aim of the present study was to compare diagnostic assessments of anterior tooth and bone status in a randomised cohort of pre-orthodontic patients using panoramic and periapical radiographs., Method: Four hundred and forty-four cases with matched periapical and panoramic radiographs were examined by three observers. Two were final-year postgraduate endodontic students and the other, a final-year Honours degree dental student. Multi-rater Kappa values were used to assess the reliability of the observers, with a value of 1 equating to complete agreement., Results: With the exception of endodontic Class 1 and 2 palatal invaginations, reliability exceeded 0.95 for all three observers. An assessment of the graduate endodontic students revealed only a marginal increase in the kappa values. Statistical analysis (p < 0.05) determined that developmental anomalies or tooth/bone pathoses were more reliably detected by observers using periapical radiographs compared with panoramic films. This finding has relevance given the likelihood of anterior dental trauma among young children., Conclusion: While there have been considerable improvements in the quality of dental panoramic radiography, the present study indicated that a reliable pre-orthodontic or post-trauma diagnostic assessment should include both panoramic and intra-oral radiographs.

This case report presents the endodontic treatment of a maxillary right lateral incisor with a perforating internal resorption in a 50-year-old woman. Radiographically, internal resorption appears as a fairly uniform, radiolucent enlargement of the pulp canal and distortion of the original root canal outline. The use of cone beam computed tomography can help the clinician in making a confirmatory diagnosis and determining the treatment plan before undertaking the actual treatment. After cleaning the root canal space and the resorptive defect by mechanic instrumentation, irrigation, and interim calcium hydroxide dressing, the apical third canal was filled with a gutta-percha point by lateral condensation. The resorptive defect was filled with mineral trioxide aggregate. Follow-up radiographs at 3 years showed adequate repair of the resorption, and the tooth remained asymptomatic.

Objective: To evaluate the long-term clinical and radiographic effects of maxillary incisor root resorption in cases of ectopic canines treated during the late 1970s and 1980s in Jönköping, Sweden., Subjects and Methods: The material comprised 55 incisors in 38 subjects. The posttreatment follow-up time was 13 to 28 years. All subjects underwent intraoral radiography, 33 were referred for computed tomography or cone beam computed tomography, and 24 also underwent clinical examination. The severity of incisor root resorption was correlated with clinical characteristics. Radiographs of the resorptive lesions were documented in detail and compared with intraoral radiographs taken immediately posttreatment., Results: Four incisors in three subjects had been lost, in part because of root resorption. Of the 36 incisors with root resorption, the lesions were unchanged in 26 teeth, improved in three teeth, and exacerbated in seven. In one case the resorption had progressed to pulpal exposure, necessitating endodontic treatment. For most of the incisors, the periodontal ligament was more clearly defined and the lamina dura showed improved trabeculation. The clinical characteristics of the incisors with resorption were not significantly different from those of sound incisors., Conclusions: In this long-term follow-up, most cases of incisor root resorption induced by ectopic maxillary canines did not progress and teeth with root resorption showed no clinically relevant symptoms. The prognosis for long-term survival of teeth with resorbed roots is good, but in cases where extraction is indicated, lateral incisors with severe root resorption should be extracted in favor of healthy premolars.

Introduction: The most frequent adverse effect of canine impaction is resorption of the adjacent incisors. The subjective image quality and the radiographic diagnostic accuracy for detection of simulated canine-induced external root resorption lesions in maxillary lateral incisors were compared among 6 cone-beam computed tomography (CBCT) systems in vitro., Methods: A child cadaver skull in the early mixed dentition was obtained. This skull had an impacted maxillary left canine and allowed a reliable simulation. Simulated root resorption cavities were created in 8 extracted maxillary left lateral incisors by the sequential use of 0.16-mm diameter round burs in the distopalatal root surface. Cavities of varying depths were drilled in the middle or apical thirds of each tooth root according to 3 setups: slight (0.15, 0.20, and 0.30 mm), moderate (0.60 and 1.00 mm), and severe (1.50, 2.00, and 3.00 mm) resorption. The lateral incisors, including 2 intact teeth, were repositioned individually in the alveolus with approximal contacts to the impacted maxillary left canine. Six sets of radiographic images were obtained with 3D Accuitomo-XYZ Slice View Tomograph (J. Morita, Kyoto, Japan), Scanora 3D CBCT (Soredex, Tuusula, Finland), Galileos 3D Comfort (Sirona Dental Systems, Bensheim, Germany), Picasso Trio (E-WOO Technology, Giheung-gu, Republic of Korea), ProMax 3D (Planmeca OY, Helsinki, Finland), and Kodak 9000 3D (Trophy, Croissy-Beaubourg, France) for each tooth setup. The CBCT images were acquired and subsequently analyzed by 12 observers. Linear models for repeated measures were used to compare the CBCT systems for the image quality and the degree of agreement between the diagnosed severity of root resorption and the true severity., Results: The differences in the image quality between CBCT systems were statistically significant (P <0.001). The root resorption scores between CBCT systems showed a significantly higher score for the ProMax when compared with the Galileos and the Kodak. However, the differences in agreement between the diagnosed severity of root resorption and the true severity for all resorption sizes were not significantly different (P >0.05) among the different CBCT systems., Conclusions: High image quality is important when detecting root resorption. The CBCT systems used in this study had high accuracy with no significant differences between them in the detection of the severity of root resorption., (Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Background: Current data suggest that a large extent of the variation in orthodontic root resorption may be explained by differences in individual genetic predisposition. This would imply, however, a similar root resorption reaction in all teeth., Objective: To determine the incidence and extent of severe external apical root resorptions (SEARR) in maxillary incisors during multibracket (MB) appliance treatment., Patients and Methods: Of the whole sample of patients having completed MB treatment at the University of Giessen between 1991 and 2010 (P(Total)=3198), all subjects exhibiting severe root resorptions on at least one maxillary incisor were selected. SEARR were defined according to Malmgren et al. [39] (grade-IV RR=resorption >1/3 root length). Evaluation was performed using orthopantomograms from before and after MB treatment. The crown and root length of the affected teeth were measured. The extent of SEARR was assessed taking pretreatment crown length into consideration., Results: SEARR was detected in 16 patients. Thus, the incidence of SEARR on maxillary incisors during MB treatment totalled 0.5%. The median of SEARR of the affected incisors was 38.6% of the initial root length (minimum=33.4%, maximum=61.0%). Most subjects exhibited only single affected teeth. Only two subjects (0.06% absolute/12.5% relative) presented four maxillary incisors with SEARR., Conclusions: The incidence of SEARR on maxillary incisors during MB treatment (0.5%) was very low compared to the literature. With only 12.5% of SEARR patients presenting four affected teeth, local rather than systemic/genetic factors seem to have predisposed the present subjects to SEARR.

Root fractures in immature teeth are rare because the resilience of the alveolar bone is more favorable to the occurrence of luxation. This article reports a case of traumatic injury in an immature permanent tooth that progressed to root fracture, having a parafunctional oral habit as the possible modifying factor of case evolution. A 12-year-old boy presented for treatment complaining of a defective restoration and mild pain on the maxillary right central incisor. The patient had a history of crown fracture in this tooth due to trauma 2 years before. The clinical examination showed healthy gingival tissues and no abnormal tooth mobility, whereas radiographic projections revealed healthy periradicular tissues, incomplete root formation, and no visible root fracture. As pulp necrosis was diagnosed, calcium hydroxide therapy was started for canal disinfection and subsequent obturation. However, after 4 weeks of treatment, a horizontal fracture line was observed radiographically in the root's middle third. The patient denied a new traumatic injury, but revealed the habit of chewing on a pencil. Refraining from the deleterious oral habit was strongly advised, and root canal filling with mineral trioxide aggregate was performed to treat the root fracture. After 4 years of follow-up, the tooth has normal function and no abnormal mobility. Images suggestive of remodeling at the apical end of the coronal segment and replacement resorption of the apical segment are seen radiographically. This case demonstrates the need of following cases of dental trauma and the possible influence of parafunctional oral habits as modifying factors of case progression.

Introduction: Invasive cervical resorption (ICR) is a type of external resorption that begins below the epithelial attachment. The etiology of ICR is mainly caused by trauma or orthodontic treatment. In many cases, cone-beam computed tomography (CBCT) is a very useful tool to achieve proper diagnosis., Methods: This case presented with invasive cervical resorption class III (Heithersay) caused by trauma on tooth #9. CBCT was performed allowing observation of the extent of the lesion in the three spatial planes., Results: Treatment was combined: surgical treatment to expose the resorptive defect and nonsurgical root canal therapy to remove the necrotic pulp and disinfect the root canal system; finally, the resorptive defect was filled up with resin ionomer (Geristore; Den-Mat Corporation, Santa Maria, CA)., Conclusions: Follow up x-ray films showed healing of the periradicular tissues, and then a control CBCT was performed to assess the reliability of the conventional x-ray film; a small periapical lesion was observed in two of the CBCT sections., (Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Background: Root resorption is one of the most common and undesirable sequelea of orthodontic treatment. The aim of this study was to evaluate the amount of root resorption in permanent incisors during 3 month active period of fixed orthodontic appliance therapy using periapical radiographs., Methods: Periapical radiographs of a total of 138 permanent teeth (n = 138, mandibular n1 = 52, maxillary n2 = 86) were evaluated for root resorption. All patients were treated with 3M MBT multi-bonded, pre-adjusted appliances with 0.022 inch slots. Initial levelling and alignment was achieved with 0.0175 inch co-axial wires. All four incisors (maxillary and mandibular) were measured for any change in root length. The change in root length between T0 (pre-treatment) and T1 (post-treatment) was measured in millimetres and expressed in terms of percentage of original root length., Results: The mean pre treatment (T0) root length for the maxillary teeth (n1 = 62) was 19.27 +/- 2.86 mm and 20.01 +/- 2.57 mm for the mandibular teeth (n2 = 31). The post-treatment (T1) root length for the maxillary teeth was 18.96 +/- 2.85 mm and 19.49 +/- 2.4 mm for the mandibular teeth showing a mean resorption of 0.31 mm and 0.52 mm for the maxillary and mandibular teeth respectively., Conclusion: Root resorption was strongly correlated with active orthodontic appliance therapy with maxillary and mandibular incisors being most susceptible. It was found that root resorption can be detected even in the early levelling and alignment stages of orthodontic treatment.