Belma Işık ASLAN, Zühre AKARSLAN, Özge KARADAĞ

APICAL ROOT RESORPTION IN TEETH AFTER THE TREATMENT OF CLASS II MALOCCLUSION WITH FORSUS FRD AND FIXED TECHNIQUE

Aim: To assess apical root resorption (ARR) after Class II malocclusion treatment with the Forsus FRD and fixed technique and to identify the possible risk factors retrospectively. Material and Methods: Seventy-three Class II patients (52 females, 21 males; mean age 14.26±1.28 years) treated with Forsus FRD and fixed technique in the department of Orthodontics were included in this study. The crown and root lengths of 1368 teeth were measured from the panoramic radiographs taken at the beginning and the end of the treatment from these patients. ARR was calculated as the root-crown ratio (RCR) and relative changes of RCR (rRCR). Apical displacement of the incisors was assessed by the superimposition of the lateral cephalograms taken at the beginning and the end of the treatment. Besides, the effect of age, gender, treatment period, tooth type, and apical displacement on ARR was evaluated. Data were statistically analyzed. Results: ARR was detected in 66 (90.41%) patients and 228 (16.67%) teeth. ARR was mild (90≤rRCR<100%) in 181 (13.23%) teeth, moderate (80≤rRCR<90%) in 30 (2.19%) teeth, and severe (rRCR ≤80) in 17 (1.24%) teeth. Severe ARR occurred mostly in the upper central and lateral teeth. A significant negative correlation was found between rRCR and, age and tooth type (p<0.05). Conclusion: Orthodontic treatment of Class II malocclusion with Forsus FRD and fixed technique could lead to mild ARR in the majority of the patients. ARR is mostly seen in the incisor teeth and increases with advanced age. Key Words: Root resorption, orthodontic appliances, malocclusion, Angle Class II SINIF 2 MALOKLÜZYONLARIN FORSUS FRD VE SABİT TEKNİK İLE TEDAVİSİ SONRASINDA DİŞLERDE GELİŞEN APİKAL KÖK REZORPSİYONU Öz Amaç: Forsus FRD ve sabit teknik ile tedavi edilen Sınıf 2 maloklüzyonların, tedavi sonrası apikal kök rezorpsiyonunun (AKR) incelenmesi ve olası risk faktörlerinin retrospektif olarak tanımlanmasıdır. Gereç ve Yöntem: Bu çalışmaya Ortodonti Anabilim Dalı’nda Forsus FRD ve sabit teknik ile tedavi edilmiş olan Sınıf 2 maloklüzyona sahip 73 hasta (52 kadın; 21 erkek; yaş ortalaması 14.26±1.28) dahil edildi. Bu hastaların, tedavi öncesinde ve tedavi sonrasında çekilen panoramik radyograflarından 1368 dişin, kron ve kök uzunlukları ölçüldü. AKR, kök-kron oranı (RCR) ve RCR’nin bağıl değişkenleri (rRCR) olarak hesaplandı. Tedavi öncesi ve tedavi sonrasında alınan lateral sefalogramların çakıştırılması ile kesici dişlerin apikal yöndeki yer değiştirmesi değerlendirildi. Bunlara ilave olarak, yaş, cinsiyet, tedavi süresi, diş tipi ve apikal yer değiştirmenin AKR’ye etkisi incelendi. Veriler istatistiksel olarak analiz edildi. Bulgular: Altmış altı hastada (%90.41) ve 228 dişte (%16.67) AKR saptandı. AKR, 181 (%13.23) dişte hafif (90≤rRCR<100%), 30 (%2.19) dişte orta (80≤rRCR<90%) ve 17 (%1.24) dişte şiddetli (rRCR ≤80) düzeydeydi. Şiddetli AKR en fazla üst santral ve lateral dişlerde görüldü. rRCR’nin yaş ve diş tipi ile anlamlı düzeyde negatif yönde ilişki gösterdiği belirlendi (p<0.05). Sonuç: Sınıf 2 maloklüzyonların Forsus FRD ve sabit tedavi ile yapılan ortodontik tedavisi, birçok hastada hafif düzeyde AKR’ye neden olabilmektedir. AKR, çoğunlukla kesici dişlerde görülmektedir ve yaşın ilerlemesiyle birlikte artmaktadır. Anahtar Kelimeler: Kök rezorpsiyonu, ortodontik gereçler, maloklüzyon, Angle Sınıf 2

Anahtar Kelimeler:

Root resorption, orthodontic appliances, malocclusion, Angle Class II

APICAL ROOT RESORPTION IN TEETH AFTER THE TREATMENT OF CLASS II MALOCCLUSION WITH FORSUS FRD AND FIXED TECHNIQUE

ABSTRACT Aim: To assess apical root resorption (ARR) after Class II malocclusion treatment with the Forsus FRD and fixed technique and to identify the possible risk factors retrospectively. Material and Methods: Seventy-three Class II patients (52 females, 21 males; mean age 14.26±1.28 years) treated with Forsus FRD and fixed technique in the department of Orthodontics were included in this study. The crown and root lengths of 1368 teeth were measured from the panoramic radiographs taken at the beginning and the end of the treatment from these patients. ARR was calculated as the root-crown ratio (RCR) and relative changes of RCR (rRCR). Apical displacement of the incisors was assessed by the superimposition of the lateral cephalograms taken at the beginning and the end of the treatment. Besides, the effect of age, gender, treatment period, tooth type, and apical displacement on ARR was evaluated. Data were statistically analyzed. Results: ARR was detected in 66 (90.41%) patients and 228 (16.67%) teeth. ARR was mild (90≤rRCR<100%) in 181 (13.23%) teeth, moderate (80≤rRCR<90%) in 30 (2.19%) teeth, and severe (rRCR ≤80) in 17 (1.24%) teeth. Severe ARR occurred mostly in the upper central and lateral teeth. A significant negative correlation was found between rRCR and, age and tooth type (p<0.05). Conclusion: Orthodontic treatment of Class II malocclusion with Forsus FRD and fixed technique could lead to mild ARR in the majority of the patients. ARR is mostly seen in the incisor teeth and increases with advanced age. Key Words: Root resorption, orthodontic appliances, malocclusion, Angle Class II SINIF 2 MALOKLÜZYONLARIN FORSUS FRD VE SABİT TEKNİK İLE TEDAVİSİ SONRASINDA DİŞLERDE GELİŞEN APİKAL KÖK REZORPSİYONU Öz Amaç: Forsus FRD ve sabit teknik ile tedavi edilen Sınıf 2 maloklüzyonların, tedavi sonrası apikal kök rezorpsiyonunun (AKR) incelenmesi ve olası risk faktörlerinin retrospektif olarak tanımlanmasıdır. Gereç ve Yöntem: Bu çalışmaya Ortodonti Anabilim Dalı’nda Forsus FRD ve sabit teknik ile tedavi edilmiş olan Sınıf 2 maloklüzyona sahip 73 hasta (52 kadın; 21 erkek; yaş ortalaması 14.26±1.28) dahil edildi. Bu hastaların, tedavi öncesinde ve tedavi sonrasında çekilen panoramik radyograflarından 1368 dişin, kron ve kök uzunlukları ölçüldü. AKR, kök-kron oranı (RCR) ve RCR’nin bağıl değişkenleri (rRCR) olarak hesaplandı. Tedavi öncesi ve tedavi sonrasında alınan lateral sefalogramların çakıştırılması ile kesici dişlerin apikal yöndeki yer değiştirmesi değerlendirildi. Bunlara ilave olarak, yaş, cinsiyet, tedavi süresi, diş tipi ve apikal yer değiştirmenin AKR’ye etkisi incelendi. Veriler istatistiksel olarak analiz edildi. Bulgular: Altmış altı hastada (%90.41) ve 228 dişte (%16.67) AKR saptandı. AKR, 181 (%13.23) dişte hafif (90≤rRCR<100%), 30 (%2.19) dişte orta (80≤rRCR<90%) ve 17 (%1.24) dişte şiddetli (rRCR ≤80) düzeydeydi. Şiddetli AKR en fazla üst santral ve lateral dişlerde görüldü. rRCR’nin yaş ve diş tipi ile anlamlı düzeyde negatif yönde ilişki gösterdiği belirlendi (p<0.05). Sonuç: Sınıf 2 maloklüzyonların Forsus FRD ve sabit tedavi ile yapılan ortodontik tedavisi, birçok hastada hafif düzeyde AKR’ye neden olabilmektedir. AKR, çoğunlukla kesici dişlerde görülmektedir ve yaşın ilerlemesiyle birlikte artmaktadır. Anahtar Kelimeler: Kök rezorpsiyonu, ortodontik gereçler, maloklüzyon, Angle Sınıf 2

Keywords:

Root resorption, orthodontic appliances, malocclusion, Angle Class II,

PDF

___

1.Kolcuoğlu K, Oz AZ. Comparison of orthodontic root resorption of root-filled and vital teeth using micro-computed tomography. Angle Orthod 2020;90:56-62.
2.Yıldırım M, Akın M. Comparison of root resorption after bone-borne and tooth-borne rapid maxillary expansion evaluated with the use of microtomography. Am J Orthod Dentofacial Orthop 2019;155:182-90.
3.Pamukçu H, Polat-Özsoy Ö, Gülşahi A, Özemre MÖ. External apical root resorption after nonextraction orthodontic treatment with labial vs. lingual fixed appliances. J Orofac Orthop 2020;81:41-51.
4. Lund H, Gröndahl K, Hansen K, Gröndahl HG. Apical root resorption during orthodontic treatment. A prospective study using cone beam CT. Angle Orthod 2012;82:480-7.
5. Linge L, Linge BO. Patient characteristics and treatment variables associated with apical root resorption during orthodontic treatment. Am J Orthod 1991;99:35–43.
6. Mirabella AD, Artun J. Risk factors for apical root resorption of maxillary anterior teeth in adult orthodontic patients. Am J Orthod 1995;108:48–55.
7. Blake M, Woodside DG, Pharoah MJ. A radiographic comparison of apical root resorption after orthodontic treatment with the edgewise and speed appliances. Am J Orthod 1995;108:76–84.
8. Weltman B, Vig KW, Fields HW, Shanker S, Kaizar EE. Root resorption associated with orthodontic tooth movement: a systematic review. Am J Orthod Dentofacial Orthop 2010;137:462–76.
9. Sameshima GT, Sinclair PM. Predicting and preventing root resorption: Part I. Diagnostic factors. Am J Orthod Dentofacial Orthop 2001;119:505–10.
10. Kaley J, PhillipsC. Factors related to root resorption in edgewise practice. Angle Orthod 1991;61:125-32.
11. Maués CP, do Nascimento RR, Vilella Ode V. Severe root resorption resulting from orthodontic treatment: prevalence and risk factors. Dental Press J Orthod 2015;20:52-8.
12. Fox N. Longer orthodontic treatment may result in greater external apical root resorption. Evid Based Dent 2005;6:21.
13. Samandara A, Papageorgiou SN, Ioannidou-Marathiotou I, Kavvadia-Tsatala S, Papadopoulos MA. Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis. Eur J Orthod 2019; 23;41:67-79.
14. Lupi JE, Handelman CS, Sadowsky C. Prevalence and severity of apical root resorption and alveolar bone loss in orthodontically treated adults. Am J Orthod Dentofacial Orthop 1996;109:28–37.
15. Kim KW, Kim SJ, Lee JY, Choi YJ, Chung CJ, Lim H, Kim KH. Apical root displacement is a critical risk factor for apical root resorption after orthodontic treatment. Angle Orthod 2018; 88:740-747.
16. Darendeliler M A , Kharbanda O P, Chan E K M, Srivicharnkul P, Rex T, Swain M V, Jones A S, Petocz P. Root resorption and its association with physical properties of, mineral contents and resorption craters in human premolars following application of light and heavy forces. Orthod Craniofac Res 2004;7:79-97.
17. Tieu LD, Saltaji H, Normando D, Flores-Mir C. Radiologically determined orthodontically induced external apical root resorption in incisors afternon-surgicalorthodontictreatment of class II division 1 malocclusion: a systematic review. Prog Orthod 2014;15:48.
18. Kinzinger GS, Savvaidis S, Gross U, Gülden N, Ludwig B, Lisson J. Effects of Class II treatment with a banded Herbst appliance on root lengths in the posterior dentition. Am J Orthod Dentofacial Orthop 2011;139:465-469.
19. Linjawi AI, Abbassy MA. Dentoskeletal effects of the forsus™ fatigue resistance device in the treatment of class II malocclusion: Asystematic review and meta-analysis. J Orthod Sci 2018;7:5.
20. Fritz U, Diedrich P, Wiechmann D. Apical root resorption after lingual orthodontic therapy. J Orofac Orthop 2003;64:434-42.
21.Krieger E, Drechsler T, Schmidtmann I, Jacobs C, Haag S, Wehrbein H. Apical root resorption during orthodontic treatment with aligners? A retrospective radiometric study. Head Face Med 2013;9:21.
22.Gay G, Ravera S, Castroflorio T, Garino F, Rossini G, Parrini S, Cugliari G, Deregibus A. Root resorption during orthodontic treatment with Invisalign: a radiometric study. Prog Orthod 2017;18:12.
23.Alver A. Erişkinlerde ortodontik tanı ve tedavi. Atatürk Üniv Diş Hek Fak Derg 1997;7:92-101.
24.Stramotas S, Geenty JP, Petocz P, Darendeliler MA. Accuracy of linear and angular measurements on panoramic radiographs taken at various positions in vitro. Eur J Orthod 2002;24:43-52
25.DeShields RW. A study of root resorption in treated Class II Division I malocclusions. Angle Orthod 1969;39:231–45.
26.Reukers E, Sanderink G, Kuijpers-Jagtman A, van't Hof M. Radiographic evaluation of apical root resorption with 2 different types of edgewise appliances. Results of a randomized clinical trial. J Orofac Orthop 1998;59:100–9.
27.Eisel A, Katsaros C, Berg R. The course and results of the orthodontic treatment of 44 consecutively treated Class-II cases. Fortschr Kieferorthop 1994;55:1–8.
28.Estrela C, Bueno MR, De Alencar AH, Mattar R, Valladares Neto J, Azevedo BC, De Araújo Estrela CR. Method to evaluate inammatory root resorption by using cone beam computed tomography. J Endod 2009;35:1491-7.
29.Kalkwarf LL, Kreyci RF, Pao YC. Effect of apical root resorption on periodontal support. J Prosthet Dent 1986;56:317–9.
30.Taner T, Ciger S, Sencift Y. Evaluation of apical root resorption following extraction therapy in subjects with Class I and Class II malocclusions. Eur J Orthod 1999;21:491–6.
31.Mavragani M, Boe OE, Wisth PJ, Selvig KA. Changes in root length during orthodontic treatment: advantages for immature teeth. Eur J Orthod 2002;24:91–7.
32.Liou EJW, Chang PMH. Apical root resorption in orthodontic patients with en-masse maxillary anterior retraction and intrusion with miniscrews. Am J Orthod Dentofacial Orthop 2010;137:207–12.
33.Martins DR, Tibola D, Janson G, Maria FRT. Effects of intrusion combined with anterior retraction on apical root resorption. Eur J Orthod 2012;34:170–5.
34.Brin I, Tulloch JF, Koroluk L, Philips C. External apical root resorption in Class II malocclusion: a retrospective review of 1-versus 2-phase treatment. Am J Orthod Dentofacial Orthop 2003;124:151-6.
35.Deng Y, Sun Y, Xu T. Evaluation of root resorption after comprehensive orthodontic treatment using cone beam computed tomography(CBCT): a meta-analysis. BMC Oral Health 2018;18:116.
36.Meriç P, Bilgiç Zortuk F, Karadede Mİ. Volumetric measurements of mandibular incisor root resorption following Forsus FRD EZ2 and Bionator appliance treatment using cone-beam computed tomography: A preliminary study. APOS Trends Orthod 2020;10:96-104.
37.Rekhawat A, Durgekar SG, Reddy S. Evaluation of root resorption, tooth ınclination and changes in supporting bone in class II malocclusion patients treated with Forsus appliance. Turk J Orthod 2020;33:21-30.
38.Casa MA, Faltin RM, Faltin K, Sander FG, Arana-Chavez VE. Root resorptions in upper first premolars after application of continuous torque moment. Intra-individual study. J Orofac Orthop 2001;62:285-95.