Orthodontic - Surgical management in a Class II case with idiopathic root resorption

Area of Science:

• Orthodontics
• Oral and Maxillofacial Surgery
• Periodontology

Background:

• Orthodontic treatment can induce or worsen root resorption, making treatment duration critical.
• Class II division 2 malocclusion with anterior crowding and idiopathic root resorption presents a complex clinical challenge.
• Accelerated treatment protocols are desirable to mitigate risks associated with prolonged orthodontic interventions.

Purpose of the Study:

• To evaluate the efficacy of a surgery-first protocol in accelerating orthodontic treatment for a patient with Class II division 2 malocclusion and root resorption.
• To assess the impact of this accelerated protocol on root resorption.
• To determine the clinical outcomes of a combined surgical and orthodontic approach.

Main Methods:

• A 14-year-old female patient with Class II division 2 malocclusion, crowding, and idiopathic root resorption underwent a surgery-first protocol.
• The protocol involved lower jaw advancement and precise interdental alveolar osteotomies.
• Postoperative orthodontic treatment was initiated one week after surgery and continued for six months with weekly activations during the first month.

Main Results:

• The surgery-first approach facilitated 'en bloc' tooth movement and enhanced bone remodeling, leading to accelerated tooth movement.
• The patient achieved satisfactory clinical resolution with no tooth loss.
• No aggravation of pre-existing root resorption was observed during the accelerated treatment period.

Conclusions:

• A surgery-first protocol combining lower jaw advancement and alveolar osteotomies can significantly accelerate orthodontic treatment.
• This accelerated approach is beneficial for patients with malocclusion and root resorption, reducing overall treatment time.
• The described surgical technique effectively managed complex malocclusion while preserving root structure.