Comprehensive Orthodontic Approach to Iatrogenic Uprighting, Apical Root Resorption, and Gingival Recession of the...

This case report presents the retreatment of a patient who experienced iatrogenic complications resulting from inadequate orthodontic diagnosis and treatment. The objective was to mitigate further risks and correct the underlying clinical issues.

A 23-year-old female patient presented with iatrogenic uprighting, apical root resorption, and gingival recession of the maxillary incisors following inappropriate orthodontic treatment. She also exhibited a transverse maxillary deficiency, which contributed to an unstable posterior occlusion and an anterior open bite. Orthodontic retreatment involved microimplant-assisted rapid palatal expansion (MARPE) to address the transverse discrepancy, resulting in improved posterior occlusion and successful closure of the anterior open bite.

Consequently, root angulation of the maxillary canines was corrected using a box loop wire, while torque control of the maxillary incisor roots was carefully managed to ensure their alignment within the alveolar bone housing.

In young adults, a transverse maxillary deficiency can be effectively managed using MARPE, which also contributes to improvements in vertical skeletal relationships. When iatrogenic root resorption and gingival recession result from improper root positioning, repositioning the affected roots may help prevent further resorption and enhance periodontal stability. Such orthodontic complications are frequently associated with excessive space closure following tooth extraction, inappropriate biomechanical strategies, prolonged treatment duration, and extensive tooth movement.