Introduction: This systematic review evaluated root resorption as an outcome for patients who received orthodontic tooth movement. Results could provide the best available evidence for clinical decisions to minimize the risks and severity of root resorption.
Methods: Electronic databases were searched, non-electronic journals hand searched and experts in the field consulted with no language restrictions. Study selection criteria included: randomized clinical trials involving human subjects for orthodontic tooth movement, with fixed appliances, and root resorption recorded during or after treatment. Two authors independently reviewed and extracted data from selected studies on a standardized form.
Results: The searches retrieved 921 unique citations. Titles and abstracts identified 144 full articles from which 13 publications remained after inclusion criteria applied. Differences in the methodologies and reporting results made statistical comparisons impossible. Evidence suggests that comprehensive orthodontic treatment causes an increase in the incidence and severity of root resorption, and heavy forces are particularly harmful. Orthodontically induced inflammatory root resorption (OIIRR) is unaffected by archwire sequencing, bracket prescription, or self-ligation. Previous trauma and tooth morphology are unlikely causative factors. There is some evidence that a 2-3 month treatment pause will decrease total root resorption.
Conclusions: Results from this systematic review are inconclusive in clinical management of OIIRR. We recommend that best practice include using light forces especially with incisor intrusion.