11/30/2022 0 Comments Cdr dicom 5.4Linear measurement of the degree of EARR was performed (in millimeters) from the root apex to the incisal edge of each incisor ( Figure 1). The Dabi Atlante X-ray machine (Dabi Atlante, Ribeirão Preto, Sao Paulo, Brazil) was used (70 kV, 08 mA) with an exposure time of 0.4 seconds for both the maxillary and mandibular incisors. For the present study, the results obtained in the first 6 months were taken into account.īefore (T0) and 6 months after (T1) initiation of the orthodontic treatment, PRs of the maxillary and mandibular incisors were obtained for the assessment of root resorption.įor standardization, all radiographs were acquired using the parallel technique with a Cone Indicator Digital Schick CDR positioner (Schick Technologies, Long Island City, NY, USA) at a distance of 40 cm, a Schick Elite CDR intraoral sensor (Schick Technologies), and the CDR DICOM for Windows program (version 5.4). In both groups, monitoring procedures were performed monthly. The appliance covered all teeth, and the same sequence of archwires was used (superelastic nitinol: 0.014”, 0.016”, and 0.016” × 0.022”). In the FA group, a fixed metallic orthodontic appliance (slot 0.022” × 0.030”, 3M Unitek, Monrovia, CA, USA) was used for treatment. The maxillary and mandibular OAs were changed every 10 days, with a recommended daily usage time of 22 hours. The sequence of procedures during treatment, such as the installation of attachments, interproximal reduction, and the application of intermaxillary elastics, among others, followed the virtual plan. Virtual planning was implemented for this group (ClinCheck TM Pro program, version 5.6 Align Technology). The OA group included patients treated with OAs (SmartTrack, Invisalign TM Align Technology, San Jose, CA, USA). Patients were randomized into two groups depending on the treatment method. Accordingly, the aim of the present randomized controlled clinical trial was to investigate and compare EARR 6 months after treatment initiation between patients treated with OAs and those treated with FAs.įor all patients, initial orthodontic assessments included the acquisition of intra- and extraoral photographs, study models, and periapical radiographs (PRs) of the maxillary and mandibular incisors. Consequently, differences in EARR between OA treatment and FA treatment remain unclear. In addition, most studies have been limited by factors such as the lack of a control group, a retrospective study design, and results entirely based on panoramic radiographs. While some authors found that patients treated with OA presented a smaller degree of EARR than did those treated with FA, 7, 9, 10 others observed similar results with the two treatment methods. 8 With regard to EARR, the reported results are controversial. In recent years, the demand for treatment with orthodontic aligners (OAs) 6, 7 has increased, considering the superior esthetics, ease of hygiene maintenance, and greater comfort when compared with fixed appliances (FAs). The patient’s response to orthodontic movement is indicated during these stages, and this helps the orthodontist to determine the individual limits of each patient. Radiographic monitoring after 6 months following orthodontic treatment initiation is essential for controlling EARR throughout treatment, because resorption can be detected from the initial stages of leveling. 4 EARR can occur in almost all teeth, although it is more evident in the maxillary and mandibular incisors, with varying degrees of severity. 3 However, an average of 1.12 mm has also been reported, with a few cases presenting with more than 2.5 mm of resorption. The average degree of root resorption in each maxillary anterior tooth is less than 1.5 mm during corrective orthodontic treatment. 1 Genetic and local factors directly related to orthodontic movement can cause EARR these include the degree and direction of forces and the treatment duration. During tooth movement, the concentration of forces on the periodontium, particularly on the apical third, can destabilize local homeostasis, resulting in loss of the surface layer of cells that protect the roots of the teeth. External apical root resorption (EARR) is a complication of orthodontic treatment that results in irreversible loss of root structure.
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