title: Orthodontically induced external apical root resorption in patients treated with fixed appliances vs removable aligners.
abstract: OBJECTIVE
  To determine whether orthodontic treatment with removable aligners vs fixed orthodontic appliances is associated with a different frequency of orthodontically induced external apical root resorption (OIEARR) when genetic, radiographic, and clinical factors are accounted for.
  
  
  METHODS
  Three hundred seventy-two orthodontic patients treated with removable aligners (Invisalign) or fixed appliances were genetically screened for interleukin 1B gene (IL1B) (rs1143634), interleukin 1 receptor antagonist gene (IL1RN) (rs419598), and osteopontin gene (SPP1) (rs9138/rs11730582). Twelve clinical variables, potentially associated with OIEARR, were also considered. Subjects were divided according to the presence of radiographically determined OIEARR (>2 mm). The association between OIEARR and appliance type, and radiographic, clinical and genetic factors, was assessed using backward stepwise conditional logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported.
  
  
  RESULTS
  Reliability of the methods was adequate. Clinical case complexity (American Board of Orthodontics [ABO] Discrepancy Index) (OR: 1.032; 95% CI: 1.005-1.061; P = .021) and extent of incisor apical displacement in the sagittal plane (OR: 1.478; 95% CI: 1.285-1.699; P = .001) were associated with an increased OIEARR risk. After adjusting for associations between clinical/radiographic/genetic factors, there were no statistically significant differences with respect to OIEARR or type of orthodontic appliance used, whether removable aligners or fixed appliances (OR: 1.662; 95% CI: 0.945-2.924; P = .078). Only subjects homozygous for the T allele of IL1RN (rs419598) were more prone to OIEARR during orthodontic treatment (OR: 3.121; CI: 1.93-5.03; P < .001).
  
  
  CONCLUSIONS
  A similar OIEARR predisposition was identified using either removable aligners (Invisalign) or fixed appliances.
authors: Alejandro
authors: A
authors: Iglesias-Linares
authors: Boris
authors: B
authors: Sonnenberg
authors: Beatriz
authors: B
authors: Solano
authors: Rosa-Maria
authors: RM
authors: Yañez-Vico
authors: Enrique
authors: E
authors: Solano
authors: Steven J
authors: SJ
authors: Lindauer
authors: Carlos
authors: C
authors: Flores-Mir
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002889:Chromosomes, Human, Pair 2; D002894:Chromosomes, Human, Pair 4; D005260:Female; D020022:Genetic Predisposition to Disease; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging; D053590:Interleukin 1 Receptor Antagonist Protein / Q000235:genetics; D053583:Interleukin-1beta / Q000235:genetics; D016015:Logistic Models; D008297:Male; D008310:Malocclusion / Q000628:therapy; D016017:Odds Ratio; D009967:Orthodontic Appliances / Q000145:classification*; D009971:Orthodontics, Corrective / Q000009:adverse effects*; D053495:Osteopontin / Q000235:genetics; D020641:Polymorphism, Single Nucleotide; D011861:Radiography, Dental / Q000379:methods; D015203:Reproducibility of Results; D012391:Root Resorption / Q000000981:diagnostic imaging / Q000209:etiology* / Q000235:genetics*; D019227:Tooth Apex; D055815:Young Adult
chemical_list: C508585:IL1B protein, human; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; C506895:SPP1 protein, human; D053495:Osteopontin
keywords: External apical root resorption; Orthodontics; Root resorption