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Prevention Of External Apical Root Resorption

Roberto Justus
Published 2015 · Medicine

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The issue of orthodontic-induced external apical root resorption (EARR) has attracted the interest of clinicians and investigators because of the alarming clinical and legal implications associated with its occurrence in a severe form. The January/February 2005 issue of the American Association of Orthodontist’s Bulletin reported that medical malpractice is a significant problem in the USA today and that patients are filing claims and lawsuits against medical and dental practitioners, including orthodontists, in record numbers. EARR is a common iatrogenic consequence of orthodontic treatment. Cross-sectional as well as longitudinal studies show that EARR is a small problem for the average orthodontic patient, with radiographic mean resorption of less than 2.5 mm. This magnitude of resorption has no adverse clinical consequences. However, 1–5 % of orthodontic patients experience a severe form of EARR, defined as exceeding 4 mm or one-third of the original root length. Severe root resorption mainly occurs in maxillary incisors. It compromises crown-root ratios and can result in tooth mobility. The main etiologic risk factor for the severe form of EARR is genetic predisposition. Emphasis is thus given on the root-sparing treatment procedures to minimize the risk for development of the severe form of EARR.
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