In 1-2% of patients, however, obvious root shortening occurs during
routine orthodontic treatment. These patients are just more genetically
susceptible to root resorption. I have even noticed that root shortening
runs in families (after noticing resorption in two children from the
same family I looked at the mom’s records and found the same thing).
This genetic predisposition is important and should be communicated to
your orthodontist if you are aware that it has been noticed in your
family.
Are there things an orthodontist can do to cause or prevent root
resorption? Some have theorized that root resorption happens if the
teeth are moved too quickly or too slowly. Teeth that are moved too
quickly may be subject to too much force they say. However, in my cases
where I’ve seen resorption I’ve used exactly the same amount of force
for exactly the same amount of time as everyone else. Braces that are on
longer logically have more time to cause a problem. Having said that,
I’ve seen transfer cases that have had braces on for more than 5 years
with no signs of root change. There really is neither documented cause
of nor protocol to follow to prevent this shortening.
So what can be done about root shortening during treatment? About the
only thing we can do as orthodontists is monitor our patients during
treatment using routine x-rays. These should be taken at least annually
as long as the braces are on. If root shortening is noticed, it should
be pointed out and discussed with the patient and their family.
Depending upon the amount of shortening, treatment may be continued as
normal, the treatment time shortened (stopping after spaces close for
example), or the braces immediately removed. It is generally believed
however that a tooth can lose up to half of its root length and never
have a problem. In my 21 years of private practice, not a single tooth
has been lost to root resorption.
Unfortunately there is nothing you can do to “re-grow” the length of
the roots. All we can do in cases like this is to educate the patients,
stabilize the teeth (passive bonded lingual retainers), and encourage
mouth guard wear for any activities that may threaten the teeth. As I’m
sure you’ve read in my article, some patients are just predisposed to
root shortening and some aren’t. The only thing the orthodontist could
have done differently is recognize the shortening earlier (i.e. 6 to 12
months in) and change the treatment goals (like leaving some uncorrected
overjet). Luckily the shortening usually stops once the orthodontic
movement stops, so it shouldn’t get any worse.
http://www.gregjorgensen.com/blog/2013/03/do-braces-make-the-roots-of-your-teeth-shorter/
Wednesday, August 31, 2016
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