Apical root resorption: the dark side of the root
Marcio José da Silva Campos1, Karine Simões Silva, Marco Abdo Gravina
1Department of Orthodontics, Juiz de Fora Federal University, Juiz de Fora, Minas Gerais, Brazil. Drmarciocampos@hotmail.com
Summary
Routine radiographs often underestimate apical root resorption. This study found significant differences in incisor root lengths, suggesting a need for advanced imaging and a new visual scale for accurate diagnosis.
Area of Science:
- Dentistry
- Orthodontics
- Radiology
Background:
- Traditional radiographs for diagnosing apical root resorption (ARR) are limited by image superimposition, potentially underestimating lesion severity.
- Accurate assessment of ARR extent is crucial for effective orthodontic treatment planning and prognosis.
Purpose of the Study:
- To measure labial and lingual root surface lengths in incisors with ARR and compare them to sagittal cone-beam computed tomography (CBCT) measurements.
- To develop and evaluate a qualitative visual scale for classifying ARR patterns.
Main Methods:
- Analysis of 82 incisors with ARR from 25 patients using CBCT in the sagittal plane.
- Comparison of labial, lingual, and longest radicular lengths.
- Five orthodontists independently classified ARR patterns using a novel visual scale at two separate times.
Main Results:
- The longest radicular length was significantly greater than the shortest surface length, indicating underestimation by standard methods.
- The developed visual scale demonstrated moderate to substantial intra- and inter-observer agreement (κ values ranging from 0.52 to 0.74).
Conclusions:
- The discrepancy between measured root lengths highlights the underestimation of ARR by conventional radiography.
- The proposed visual scale offers a reliable tool for assessing ARR patterns, with agreement frequencies above 65%.
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