The aim of the study was to compare the extent of maxillary incisor root resorption during different orthodontic tooth movements using three different techniques, namely the basal intrusion arch, the three component arch, and levelling of the upper dental arch with the straightwire appliance. The radiographs of 49 subjects (20 males and 29 females) with a mean age of 14.5 years were taken at two time points: in groups 1 and 2 after the levelling phase and in group 3 immediately after placement of the archwire (T1) and in all groups after a period of 6 months (T2). The amount of root resorption of the central incisors was determined at T2. The average incisor resorption was different in the three groups, with group 2 (three component arch) showing greater resorption (0.46 mm) than groups 1 (basal arch) and 3 (straightwire) of 0.26 and 0.25 mm, respectively. Analysis of variance (ANOVA) demonstrated that differences in root resorption in the three groups were not significant. Wilcoxon paired test showed that the root resorption occurring between T1 and T2 in the three groups was not significant. There was also no significant difference among the rates of resorption in the three groups. Grouping the subjects on the basis of the extent of root resorption and the biomechanics used showed differences in the percentage of subjects with the least (<0.5 mm) and greatest (0.5-0.9 mm) amounts of root resorption between the three groups. This again showed that the technique of three component intrusion arch resulted in the greatest increase in root resorption.
Root resorption is an undesirable sequela of orthodontic tooth movement. The odontoclasts are responsible for root resorption and the process of hyalinization is known to preceed the orthodontic root resorption. It is found that there are several predisposing factors, therefore an evaluation of these factors should be done by careful examination of personal medical history, severity of malocclusion and dental treatment (if any due to previous history of trauma), anterior crossbite etc. The evaluation becomes an essential factor as it helps the orthodontists in detecting the occurance and severity of the root resorption and thereby plan out the treatment more effectively. Orthodontic tooth movements especially intrusion and other movements like tipping, torque are all known to influence the root resorption, therefore the detection using radiographs and repair of root resorption is of utmost significance as root resorption is a more serious problem from a medicolegal stand point of view. However some studies have shown that the repair process is known to occur after the cessation of orthodontic treatment by the deposition of cementum of cellular type. In the light of orthodontist’s liability of what is basically an unpredictable phenomenon, it is necessary that the speciality define this uncertainity and protect its members against unnecessary and unjustified litigation.
Summary:The evaluation of the treatment results is normally done to estimate the nature and quality of work, so that justice can be done to the work that we do and also that the patients will be satisfied. The primary motive of every orthodontist should be to treat the patient effectively and successfully with long lasting results. Thus the patients are to be assessed, using an appropriate method. PAR index was developed in the recent years to evaluate the treatment results and it is considered as a simple, objective and a reliable manner for evaluating the stability after orthodontic treatment. The index can be applied to different components of the dentition and scores are applied to each component after which the individual scores are multiplied with their respective weightings to balance the impact of the individual components of the overall result. They are then summed up to establish an overall total. In this manner, the method was carried out for the study casts of the three different phases of the treatment i.e. before the onset of the treatment, immediately after treatment and 2 years after treatment for assessing the stability after orthodontic treatment.
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