Changes in root length during orthodontic treatment: advantages for immature teeth

The purpose of the study was to investigate root lengthening during orthodontic treatment in relation to the age of the patient, the developmental stage of the root, and the anticipated growth. Specifically, the potential benefit of treating young teeth was addressed. The sample consisted of 80 patients with Angle Class II division 1 malocclusions, treated with extraction of at least two maxillary first premolars, and edgewise technique with 0.018-inch slot brackets. Additionally, a cross-sectional control group of 66 untreated individuals matched to gender, and pre- and post-treatment age of the experimental group was included. Crown and root lengths of the maxillary incisors were measured on peri-apical radiographs before and after treatment, and corrected for image distortion. The stage of root development before treatment was recorded. Root elongation during treatment was found for 50 out of the 280 examined teeth. Age at treatment start was significantly higher among the patients showing root shortening of the lateral incisors during treatment than among those showing root elongation (P < 0.05). The stage of root development was significantly related to the direction of root length change, i.e. shortening or elongation. Roots elongated during treatment did not differ in length from untreated teeth of similarly aged individuals. There was no significant difference in the extent of root lengthening between the roots elongated during treatment and the normal root lengthening in age-matched untreated individuals. Post-treatment root length was significantly related to pre-treatment age. Roots that were incompletely developed before treatment reached a significantly greater length than those that were fully developed at the start of treatment. The results of this study show a definite advantage for younger teeth with regard to post-treatment root length. This finding may influence treatment planning strategy.