A radiographic analysis of external apical root resorption of maxillary incisors during active orthodontic treatment

External apical root resorption (EARR) is an undesirable consequence of orthodontic treatment. The purpose of this study was to measure the amount of EARR and to examine its clinical significance in maxillary incisors, during a 12-month active treatment period. A further aim was to examine the contribution of gender, treatment technique, treatment duration, and extraction of maxillary first premolars to EARR. The sample comprised 151 maxillary incisor teeth in 40 patients (16 males, 24 females) aged 12-22 years, with different malocclusions. Standard periapical radiographs, using the long-cone paralleling technique, were obtained before and 6 and 12 months after the start of treatment. Quantitative measurements for 80 central and 71 lateral maxillary incisors were performed separately and corrected for image distortion. Root length reduction was calculated in millimetres and in terms of the percentage of the original root length. Resorption of more than 1 mm at 12 months of active treatment was considered to be clinically significant. On average, the degree of EARR for the maxillary central incisors was 0.77 +/- 0.42 and 1.67 +/- 0.64 mm, respectively, during the 6- and 12-month follow-up (P < 0.001). For the lateral incisors, the degree of EARR was 0.88 +/- 0.51 and 1.79 +/- 0.66 mm, respectively (P < 0.001). Clinically significant: resorption was found for 74 per cent of the centrals and 82 per cent of the laterals. No significant correlation was observed between EARR and treatment technique. EARR was found to be correlated with gender for the lateral incisors. The effect of treatment duration (P < 0.001) and premolar extraction (P < 0.001) was statistically significant for both tooth groups.