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Quantifying Root Resorption on the Incisors After Clear Aligner and Fixed Appliance Therapy Using Artificial
Roberto Bespalez-Neto1, Claudia Trindade Mattos2, Lucia Helena Soares Cevidanes3
1Department of Orthodontics, School of Dentistry, Uniderp, Campo Grande, Mato Grosso do Sul, Brazil.
Orthodontics & Craniofacial Research
|December 30, 2025
Summary
External apical root resorption (EARR) occurred in both clear aligner and fixed appliance treatments for Class I malocclusion. Upper lateral incisors showed the most significant EARR, regardless of the orthodontic appliance used.
Area of Science:
- Orthodontics and Dentofacial Orthopedics
- Dental Imaging and Diagnostics
- Biomaterials and Biomechanics
Background:
- External apical root resorption (EARR) is a potential side effect of orthodontic treatment.
- Quantifying EARR accurately is crucial for understanding treatment outcomes and patient safety.
- Novel 3D analysis techniques offer improved precision in measuring EARR.
Purpose of the Study:
- To compare the incidence and severity of EARR in incisors following non-extraction Class I malocclusion treatment using clear aligners versus fixed appliances.
- To evaluate the efficacy of a novel 3D analysis of Cone-Beam Computed Tomography (CBCT) derived surface models for quantifying EARR.
- To identify patient or treatment-related factors associated with EARR.
Main Methods:
- A randomized clinical trial involving 32 adult patients with moderate crowding was conducted.
- Patients were treated with either clear aligners (n=15) or fixed appliances (n=17).
- CBCT scans pre- and post-treatment were analyzed using a novel surface-based 3D method to measure EARR.
Main Results:
- The overall median EARR was -0.72 mm, with no statistically significant difference between clear aligners (-0.71 mm) and fixed appliances (-0.72 mm).
- Upper lateral incisors demonstrated significantly greater EARR compared to lower incisors and upper central incisors (p < 0.001).
- No significant predictors for EARR were identified, including age, sex, crowding severity, or treatment duration.
Conclusions:
- Non-extraction orthodontic treatment for Class I malocclusion, using either clear aligners or fixed appliances, results in EARR.
- Upper lateral incisors are the most susceptible to EARR during this type of orthodontic treatment.
- The novel 3D analysis method provides a comprehensive and potentially standardized approach for EARR quantification, highlighting the importance of monitoring root health, especially in upper lateral incisors.
