Korean J Orthod.  2024 Nov;54(6):392-402. 10.4041/kjod24.109.

Factors affecting external apical root resorption of maxillary incisors associated with microimplantassisted rapid palatal expansion

• Chang JH
• Lee JW

• KMID: 2561600
• DOI: http://doi.org/10.4041/kjod24.109

Abstract

Objective
To measure and compare the extent of root resorption in the maxillary incisors following microimplant-assisted rapid palatal expansion (MARPE) and to identify risk factors of root resorption after expansion.
Methods
Cone-beam computed tomography images were obtained from a total of 60 patients both before expansion (T1) and 3 to 6 months after expansion (T2). Measurements taken included tooth length, root length, crown length and center of resistance. Resorption length (RL) and resorption length percentage (RLp), resorption volume (RV) and resorption volume percentage (RVp) and the amount of expansion were calculated.
Results
A significant difference in tooth length and volume was observed in both the central and lateral incisors before and after expansion. The resorption index (RL, RLp, RV, RVp) was significantly higher in the central incisors than in the lateral incisor. There was a significant correlation between several factors: age and RLp of the central incisors, the amount of expansion and RVp of the central incisors, tooth length of the central incisors and RL, RLp of the central incisors, root/crown ratio of the central incisors and RL of the central incisors, as well as tooth length of the lateral incisors and the RL of the lateral incisors.
Conclusions
Significant root resorption occurs in maxillary incisors following MARPE, with central incisors root resorption being significantly higher than lateral incisors. Key risk factors for root resorption after MARPE include advanced age, a larger amount of expansion, initial tooth length, and a root/crown ratio.

Keyword

Expansion; Root resorption; Computed tomography; Microimplant

Figure

• 

  Figure 1 Re-orientation. A, Axial view: the reticle is set to pass through the widest part of the incisor’s buccolingual and mesiodistal regions. B, Coronal view: the reticle is set to pass through the apex and midpoint of incisal edge. C, Sagittal view: measurements were performed. L, tooth length; r, root length; c, crown length.

• 

  Figure 2 Measurement of center of resistance (Cre) by connecting the first molars’ bifurcation point before (A) and after (B) microimplant-assisted rapid palatal expansion. The Frankfort Horizontal plane was used as the horizontal reference plane. The amount of expansion was defined as the difference in Cre measured between T1 and T2 period.

• 

  Figure 3 Measurement of tooth volume (V) by InVivo Dental 5 software.

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  Figure 4 Pearson correlation scatterplot. The scatterplot shows a positive coefficient, which indicates that as age increases, the resorption length percentage of the central incisors (RLp1) increases.

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  Figure 5 Pearson correlation scatterplot. The scatterplot shows a positive coefficient, which indicates that as the amount of expansion (E) increases, the resorption volume percentage of the central incisors (RVp1) increases.

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  Figure 6 Pearson correlation scatterplot. The scatterplot shows a positive coefficient, which indicates that the longer the initial central incisor tooth length (L1), the greater the resorption length of the central incisor (RL1) and resorption length percentage of the central incisors (RLp1).

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  Figure 7 Pearson correlation scatterplot. Scatterplot shows a positive coefficient, which indicates that the higher the root/crown ratio of the initial central incisor (R1), the greater the resorption length of the central incisor (RL1).

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  Figure 8 Pearson correlation scatterplot. Scatterplot shows a positive coefficient, which indicates that the longer the initial lateral incisor tooth length (L2), the greater the resorption length of the lateral incisors (RL2).

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  Figure 9 Comparison of tipping movement and center of resistance (red dots) change between before and after root resorption. A, In normal central incisors, the force of the transseptal fibers (red lines) is applied relatively coronal to the center of resistance, causing crown mesial tipping and root distal tipping movement. B, When root resorption occurs, the center of resistance moves to the coronal side. Consequently, the force of the transseptal fibers is applied relatively more apically to the center of resistance, reducing crown mesial tipping and root distal tipping movement.

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