An unusual case of invasive cervical resorption after piezosurgery-assisted en masse retraction

Abstract

An unusual case of invasive cervical resorption after piezosurgery-assisted en masse retraction Nil€ ufer _ Irem Tunç er, a Cansu K€ oseo glu-Seç gin, b and Ayç a Arman-€ Ozç ırpıcı a Ankara, Turkey A 16-year-old patient sought orthodontic correction for profile improvement and labially inclined maxillary incisors. She had Class II malocclusion, protrusive maxillary and mandibular incisors, and increased overjet and overbite with an American Board of Orthodontics discrepancy index value of 25. She was treated with maxillary premolar extractions and miniscrew-supported en masse retraction assisted with piezoincisions. Extraction spaces (7.5 mm per side) were closed with maximum anchorage in 10 months. Total treatment time was 23 months. Twenty-seven months after debonding, a pink spot was noted at the buccocervial region of the left central incisor. Radiographic evaluation on cone-beam computed tomographic scans revealed a severe case of invasive cervical resorption on both central incisors, around which the piezosurgical cuts had been made. Treatment proceeded with a nonintervention approach and the affected teeth were reinforced with a lingual retainer.

Multiple idiopathic external cervical root resorption in patient treated continuously with denosumab: a case report

“…TNF-α has a fundamental role in osteoclastogenesis and may stimulate osteoclast differentiation in the presence of M-CSF independent of the RANK-RANKL system [ 40 , 41 ]. Macrophage-colony stimulating factor (M-CSF) is an essential factor involved in the proliferation and differentiation of osteoclasts from their progenitors and histological studies show that local trauma to the bone or periodontal ligament increases the concentrations of M-CSF [ 7 – 9 , 43 ]. This finding may explain the progressive external root resorption by activated odontoclasts in conditions of suppressed RANK/RANKL signaling during denosumab treatment and advanced periodontitis.…”

“…RANK/RANKL/OPG plays an essential role in osteoclastogenesis and osteoclastic bone resorption [ 6 ]. Histological studies show that local trauma to the bone or periodontal ligament increases the concentrations of RANKL, macrophage-colony stimulating factor (M-CSF), tumor necrosis factor alpha (TNF-α), interleukin 1β (IL-1β) and other inflammatory cytokines that stimulate osteoclast and odontoclast differentiation [ 7 – 9 ]. Denosumab is a novel variant of antiresorptive therapy used to treat osteoporosis (e.g., Prolia 60 mg every 6 months) or to treat or prevent skeletal complications in malignancies (e.g., Xgeva 120 mg up to once every month) [ 10 ].…”

The transparency of reporting 'harms' encountered with the surgically assisted acceleration of orthodontic tooth movement in the published randomized controlled trials: a meta-epidemiological study

“…Surgical acceleration methods all rely on one principle, the 'regional acceleratory phenomenon (RAP)', which was described by Frost as a complex reaction of tissues to a harmful stimulus [ 4 ]. However, surgical interventions may be associated with many undesirable side effects such as tooth resorption as was reported by Tunçer et al [ 5 ]. They notified exposure of the central incisors to severe cervical resorption in a patient who underwent en masse retraction following premolars extraction assisted with piezoincisions [ 5 ].…”

“…However, surgical interventions may be associated with many undesirable side effects such as tooth resorption as was reported by Tunçer et al [ 5 ]. They notified exposure of the central incisors to severe cervical resorption in a patient who underwent en masse retraction following premolars extraction assisted with piezoincisions [ 5 ]. On the other hand, there have been other several reports regarding injuries associated with the surgical acceleration techniques like interdental bone loss [ 6 , 7 ], tooth vitality loss [ 6 , 8 ], scarring of the surgical site [ 9 , 10 ], gingival recession [ 6 , 11 ], mechanical root injury during surgery [ 12 , 13 ], face and the neck subcutaneous hematomas [ 6 ], and bacteremia [ 14 ].…”