An Evidence Based Approach To External Apical Root Resorption Anne Marie Kuijpers Jagtman. Episode 56. IOC 2020

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Farooq Ahmed

Root resorption

Shape of periodontal ligament – middle PDL is the narrowest aspect = biggest risk of hylinisation


When hylinisation occurs

  • Necrotic tissue require to be removed
  • Done via mono and multinucleated cells- / macropharges. Produce cytoclines which differentiate osteoclasts
  • Root resorption occurs around an area of hylinsation
  • Time line – after 10 day Brudvik 1995


Incidence of RR

  • 90% of all patients show some signs of RR
  • 18% greater than 2mm
  • 1-5% greater than 1/3 of root


RR at 6 months is correlated to RR at the end of treatment 0.6-0.7



  • Take OPG 12 months in treatment
  • Extraction treatment has a higher risk of RR


What to do if RR?

  • Very little literature
  • 2mm+ if detected – discuss with patient objectives
  • 3 months no forces for Levander 1993
  • Avoid forces to tooth with RR
  • Retake radiograph 6/12 after restart


 Development of clinical practice guideline for orthodontically induced external root resorption Sondeijker 2020


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