What do you think about orthodontic forces on root filled tooth? Have you ever noticed any differences between this case and controlateral vital tooth? In literature, the most part of studies is based on bidimensional radiographic exams.
I am evaluating it on CBCT and I would like to share ideas. Thanks for the attention.
Orthodontic tooth movements concerning with sourounding bone
rather than vitality of the tooth
If the tooth perfectly filled endodontically
If the tooth filled recently it does not any differences but after a period of time the tooth become more brittle due to loss of vascularity that effect finally in the tooth it self that cannot undergo excessive force which cause root surface resorption.
Ehab A. Abdulghani Thank you for the answer. According to your experience, how long after could it happen? Moreover, shouldn't the loss of vascularity cause the absence of that inflammatory pathway, typical of root resorption?
thank you for this controversial situation>>>> Dear Dr. Gentile
Differences in Root Resorption between Root Canal treated and contralateral vital tooth during Orthodontic Tooth Movement: A Systematic Review
It is believed that root canal treated tooth apex goes under more resorption than contralateral vital tooth during orthodontic movement. The concept is still contradictory and therefore the aim of this systematic review was to search the evidence regarding this issue. The clinical trials performed on human subjects with vital and contralateral root canal treated tooth were included in the study. The evidence was searched in PubMed, EMBASE, Medline, Cochrane and Scopus. No language barrier was imposed. From the analysis, it found that there was no difference in the amount of root resorption between vital and contralateral tooth. But, the degree of resorption was determined by the intensity of force applied, force application technique (continuous or interrupted), duration of force application and direction of the force application. Form the above fact it can be concluded that root canal treated tooth can be moved equal distance as a vital contralateral tooth. Orthodontic Journal of Nepal, Vol. 6 No. 1, June 2016, pp.41-44
I think it differes from person to another, from male to female ,according to ethical and regional but almost it take a period from six month to two year to become brittle .whenever the time passes whenever it become more brittle and undergo resorption . that doesn't mean if the tooth is vital also doesn't undergo resorption , it also resorbed but less than the nonvital tooth and after long period .also according to the type and an amount of force .
In regards of root resorption my opinion is that there is no significant difference in treated vs non treated teeth. In regards of movement in my experience there is always some small difference in patient response left vs right side, no matter if there are treated or untreated teeth.
Literature says chances of root resprption is more with root canal treated but as such I have not noticed any difference in tooth movement but one should be careful as chances of flare up and resorption is always there.
I have noticed no difference. There is no extra root resorption seen nor the tooth movement is slow.
I haven't noticed any diference clinically, but you might find our article interesting. The meta-analysis showed that the relevant data seem to imply that root resorption is less in endodontically treated teeth:
Article Root resorption of endodontically treated teeth following or...
In my 20 years practice I haven't seen any difference in tooth moment and root resorption. There is also no evidence in literature. If you think about the tooth moment the remodelling take place in surroundings bone sockets. force and other inflammatory process occurs with in the bone and PDL so remodelling take place normally if others factors were not exist.
hi my dear
surely there was a difference when we are dealing with a vital tooth we can manage all type of forces applied while in case of filled root our force will applied with cations
The filled tooth move slower than the contralateral vital tooth.
Note:
In the posterior region of the mouth, I prefer to extract the filled tooth and make some changes in the ideal treatment plan.
Since the excellent metanalysis of Ioannidou-Marathiotou I, et al (Ioannidou-Marathiotou I, et al. Root resorption of endodontically treated teeth following orthodontic treatment: a meta-analysis. Clin Oral Investig . 2013 Sep;17(7):1733-44.), their conclusions were confirmed by the recent metanalysis of Alhadainy HA, et al. ( Alhadainy HA, Flores-Mir C, Abdel-Karim AH, Crossman J, El-Bialy T. Orthodontic-induced External Root Resorption of Endodontically Treated Teeth: A Meta-analysis. J Endod. 2019 May;45(5):483-489.) which, incidentally, omitted to cite that of Ioannidou-Marathiotou I, et al.
I attach little importance to my personal clinical experience on this issue, even though it seems to corroborate the results of the published studies.
In total, the amount of orthodontic-induced external root resorption of endodontically treated teeth compared with contralateral vital pulp teeth treatment is significantly less
Root resorption is a multifactorial process. That is why some studies have shown increased root resorption in non-vital teeth whereas some others found no difference. This is because of the multiple confounding factors which may be difficult if not impossible to control. The best management is to be aware of the potential root resorption and efficient orthodontic mechanics to complete the treatment in the shortest time possible. Our group published a meta analysis on root resorption with clear aligners and fixed orthodontic therapy. Please see below.
Gandhi V, Mehta S, Gauthier M, et al. Comparison of external apical root resorption with clear aligners and pre-adjusted edgewise appliances in non-extraction cases: a systematic review and meta-analysis. Eur J Orthod. 2021;43(1):15-24. doi:10.1093/ejo/cjaa013
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