title: A comparison of apical root resorption after orthodontic treatment with surgical exposure and traction of maxillary impacted canines versus that without impactions.
abstract: OBJECTIVE
  Orthodontic management of maxillary canine impaction (MCI), including forced eruption, may result in significant root resorption; however, the association between MCI and orthodontically induced root resorption (OIRR) is not yet sufficiently established. The purpose of this retrospective cohort study was to comparatively evaluate the severity of OIRR of maxillary incisors in orthodontically treated patients with MCI. Additionally, impaction characteristics were associated with OIRR severity.
  
  
  METHODS
  The sample comprised 48 patients undergoing fixed-appliance treatment-24 with unilateral/bilateral MCI and 24 matched controls without impaction. OIRR was calculated using pre- and post-operative panoramic tomograms. The orientation of eruption path, height, sector location, and follicle/tooth ratio of the impacted canine were also recorded. Mann-Whitney U-test and univariate and multivariate linear mixed models were used to test for the associations of interest.
  
  
  RESULTS
  Maxillary central left incisor underwent more OIRR in the impaction group (mean difference = 0.58mm, P = 0.04). Overall, the impaction group had 0.38mm more OIRR compared to the control (95% confidence interval, CI: 0.03, 0.74; P = 0.04). However, multivariate analysis demonstrated no difference in the amount of OIRR between impaction and non-impaction groups overall. A positive association between OIRR and initial root length was observed (95% CI: 0.08, 0.27; P < 0.001). The severity of canine impaction was not found to be a significant predictor of OIRR.
  
  
  CONCLUSIONS
  This study was a retrospective study and used panoramic tomograms for OIRR measurements.
  
  
  CONCLUSIONS
  This study indicates that MCI is a weak OIRR predictor. Interpretation of the results needs caution due to the observational nature of the present study.
authors.affiliation: *Orthodontic Department, School of Dentistry, University of Athens, Greece, evalempesi@yahoo.gr.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Lempesi
authors.affiliation: **Private Practice, Corfu, Greece, ***Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Switzerland.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Pandis
authors.affiliation: ****Institute of Dentistry, Queen Mary University of London, UK.
authors.forename: Padhraig S
authors.initials: PS
authors.lastname: Fleming
authors.affiliation: *Orthodontic Department, School of Dentistry, University of Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Mavragani
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003481:Cuspid / Q000601:surgery; D003795:Dental Sac / Q000473:pathology; D005260:Female; D006801:Humans; D007180:Incisor / Q000601:surgery; D008297:Male; D008437:Maxilla / Q000601:surgery*; D050793:Orthodontic Extrusion / Q000009:adverse effects* / Q000379:methods; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D012391:Root Resorption / Q000000981:diagnostic imaging / Q000209:etiology*; D014078:Tooth Eruption; D014095:Tooth, Impacted / Q000601:surgery*; D014143:Traction / Q000009:adverse effects; D055815:Young Adult