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Case Video Presentation: Thinking out of the ‘bracket’… Is partial orthodontic treatment acceptable?

Asef KarimThis case is presented by Dr. Asef Karim, DMD, MPH, MSc, FRCD(C)

Courtesy of Elsevier, you can access the following full-text article for the next 3 months: Root resorption associated with orthodontic tooth movement: A systematic review (2010)

One of the risks and potential sequela of fixed orthodontic treatment is the shortening of roots commonly known as orthodontically induced inflammatory root resorption (OIIRR). In its severest form, OIIRR can cause tooth mobility and can compromise the long-term prognosis of teeth. If a patient is at risk for OIIRR and requires orthodontic intervention (for example, has an impacted canine) it is important to consider an overall force system that is conservative and delivers light intermittent forces rather than comprehensive traditional braces that apply heavier continuous forces.

Key Messages 

  1. The etiology of root resorption is multi-factorial and some risk factors include: genetics, gender, tooth root morphology and length, systemic factors, iatrogenic orthodontic concerns, and tooth type.
  2. A detailed family history is helpful if root resorption is noted.
  3. Early panoramic x-rays are valuable for orthodontic diagnosis because they give a broad view, can verify the presence of all permanent teeth, and can help identify any pathology or impacted teeth.
  4. A severely angulated or impacted canine, if noticed early, can be monitored and early orthodontic intervention can assist in the eruption of that permanent canine.
  5. If an individual exhibits root resorption prior to orthodontic treatment, then he or she is at risk for further OIIRR during orthodontic treatment.
  6. Properly planned orthodontic treatment can help to minimize the risk and further extent of root resorption.
  7. The video below details the diagnosis, treatment planning, and orthodontic rehabilitation of a Hispanic male adolescent who was at high risk for orthodontically induced inflammatory root resorption and had an impacted maxillary canine. 

Watch the Case Video



  1. Weltman B et al.  Root resorption associated with orthodontic tooth movement:  A systematic review. Am J Orthod Dentofacial Orthop. 2010, 137(4):462-476.
  2. Artun J, Van’t Hullenaar R, Doppel D, and Kuijpers-Jagtman AM. Identification of orthodontic patients at risk of severe apical root resorption. Am J Orthod Dentofacial Orthop. 2009 Apr;135(4):448-55.
  3. Poumpros E, Loberg E, Engstrom C. Thyroid function and root resorption. Angle Orthod 1994;64:389-93.
  4. Shirazi M, Dehpour AR, Jefari F. The effect of thyroid hormone on orthodontic tooth movement in rats. J Clin Pediatr Dent 1999; 23:259-64.
  5. Olive, RJ, Orthodontic treatment of palatally impacted maxillary canines. Australian Orthodontic Journal. 2002;18(2):64-71.
  6. Ericson S and Kurol J. Early treatment of palatally erupting maxillary canines by extraction of the primary canines. European Journal of Orthodontics 1988:283-295.
  7. Cooke J and Wang HL. Canine impactions: incidence and management. Int J Periodontics Restorative Dent 2006 Oct;26(5):483-491.


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1 Comment

  1. VR June 14, 2014

    Thanks for the very informative video!


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