Lower Incisor Root Resorption after Orthodontic Alignment and Leveling
DOI:
https://doi.org/10.17921/2447-8938.2019v21n5p494-499Resumo
Abstract
The objective of this study was to evaluate the external apical root resorption in the lower incisors after orthodontic alignment and leveling using digital periapical radiographs. The sample consisted of periapical radiographs of 90 lower central incisors from 45 patients, 19 men and 26 women aged 12-36 years (mean 22.7 years). All the 90 lower central incisors were performed periapical radiographs in two phases: 1 - initial before orthodontic treatment and 2 - after alignment and dental leveling phase. The initial periapical radiographs were digitized through a transparency scanner. All patients were treated by the same orthodontist, the inclusion criteria were: never having been treated orthodontically; absence of exodontia, agenesis, malformation or defect in teeth, supernumerary teeth, endodontic treatment and impacted incisors. The time interval between the initial and post-leveling radiographs was from 6 to 12 months, with an average time of 9 months. It was observed that 47.8% of the incisors evaluated presented external apical root resorption, being most grade 1 (irregular contour up to 1 mm reabsorption). There was a positive association of external root resorption with the triangular root shape. There was no association between the severity of root resorption and the type of malocclusion. An association was observed between age and resorption severity, that is, patients who have already reached bone maturation were more likely to develop apical external root resorption. Female patients were more likely, but when men developed external root resorption, it tended to be a more severe degree. Female adult patients, with a triangular root shape, anatomical apical pipette shape, regardless of malocclusion type are more likely to develop apical external root resorption in orthodontic treatment.
Keywords: Radiography, Dental, Digital. Orthodontic. Root Resorption.
Resumo
Esse estudo teve como objetivo avaliar a reabsorção radicular apical externa nos incisivos inferiores após alinhamento e nivelamento ortodôntico com radiografias periapicais digitais. A amostra consistiu de 90 radiografias periapicais de incisivos centrais inferiores de 45 pacientes, sendo 19 homens e 26 mulheres com idade entre 12 e 36 anos (média de 22,7 anos). As radiografias periapicais foram realizadas em dois momentos: 1 - inicial antes do tratamento ortodôntico e 2 - após fase de alinhamento e nivelamento dentário. Todas as radiografias foram digitalizadas através de um scanner de transparência. Todos os pacientes foram tratados pelo mesmo ortodontista e preenchiam os seguintes critérios de inclusão: não ter sido tratado ortodonticamente anteriormente; ausência de exodontia, agenesia, malformação ou defeito nos dentes, dentes supranumerários, tratamento endodôntico e incisivos impactados. O intervalo de tempo entre as radiografias inicial e pós-nivelamento foi de 6 a 12 meses, com tempo médio de 9 meses. Observou-se que 47,8% dos incisivos avaliados apresentaram reabsorção radicular apical externa, sendo a maioria de grau 1 (contorno irregular até reabsorção de 1 mm). Houve associação positiva da reabsorção radicular externa com a forma da raiz triangular. Não houve associação entre a gravidade da reabsorção radicular e o tipo de má oclusão. Observou-se associação entre idade e gravidade da reabsorção, ou seja, pacientes que já atingiram a maturação óssea apresentaram maior chance de desenvolver reabsorção radicular externa apical. Pacientes do sexo feminino foram mais frequentes, mas quando os homens desenvolveram reabsorção radicular externa, tenderam a ser mais graves. Um paciente adulto, do sexo feminino, com formato de raiz triangular, região apical na forma anatômica de pipeta, independentemente do tipo de má oclusão, tem maior probabilidade de desenvolver reabsorção radicular externa no tratamento ortodôntico.
Palavras-chave: Radiografia Dentária Digital. Ortodontia. Reabsorção da Raiz.
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