An Assessment of the Effects of Orthodontic Treatment after Apexification of Traumatized Immature Permanent Teeth: A Retrospective Study

Abstract

Introduction: Root resorption may occur in traumatized necrotic teeth that have undergone apexification after orthodontic treatment. This study examined the effects of orthodontic treatment on the outcome of apexification.

Methods: This retrospective study included 36 children presenting with anterior permanent traumatized teeth with immature roots who were treated by apexification and root canal treatment. The orthodontic group consisted of 17 children with 24 teeth that were subjected to orthodontic treatment after apexification. The control group consisted of 19 children with 21 teeth that underwent only apexification without orthodontic treatment. Almost half of the teeth in both groups underwent apexification with calcium hydroxide, whereas the other half were treated with mineral trioxide aggregate. The effects of sex, stage of root development, and apexification material on the outcomes of apexification were analyzed and compared between the 2 groups.

Results: Apexification was successful in 88% of cases after at least 5 years of follow-up. Neither apexification technique nor sex had a significant effect on treatment outcome. The stage of root development had a positive effect on outcome, although it was not statistically significant. Some root resorption (average = 0.3 mm) was observed after orthodontic treatment, whereas teeth that underwent apexification without orthodontic treatment exhibited some root elongation (average = 0.1 mm). This difference was highly significant.

Conclusions: Minor root resorption was observed in the orthodontic group compared with a minor increase in root length in the control group. Orthodontic movement of immature traumatized teeth after apexification appears to be safe.

Keywords: Apexification; orthodontic treatment; root resorption; trauma.