The Prevalence of Root Resorption in a Sample of Orthodontic Patients Treated in Private Clinics in Sulaimani City/ A Retrospective Study


  • Sana T. Omer Orthodontic Department, College of Dentistry, University of Sulaimani, Kurdistan Region, Iraq. Author
  • Adham A. Abdulrahman Orthodontic Department, College of Dentistry, University of Sulaimani, Kurdistan Region, Iraq. Author



AutoCAD, Orthodontic treatment, Orthopantomograms, Root resorption, Webceph


Objective: Root resorption is an inevitable consequence of orthodontic treatment. This retrospective study aimed to determine the
prevalence of root resorption secondary to orthodontic treatment in private clinics in Sulaimani City, Iraq and to compare the difference in the amount of root resorption between varying teeth, regions of the mouth, and the upper and lower arches in order to lessen or eliminate unsolicited and undue impediments.

Methods: Among the 465 cases with available data, treated in private clinics of the participating practitioners, only 92 were fully
eligible for study. Pre-operative lateral cephalograms were measured using Eastman Analysis on WebCeph. A customized frame was
created on AutoCAD and pre and post-operative orthopantomograms were measured for root resorption only if they fitted into the
frame. Intra and inter-observer reliability were performed to ensure optimal accuracy in the measurements. The millimeter
measurements of root resorption were converted into percentages to identify the prevalence of root resorption in Sulaimani City.

Results: The root resorption in the different individual teeth resulted in a significant relationship with orthodontic treatment. Factors
such as age, gender, and duration of treatment were not significantly associated with root resorption. The results of the upper and lower arches indicated no significant differences between the arches. The incisors showed more significant resorption when compared to canines.

Conclusions: Orthodontic treatment affects the prevalence and severity of root resorption. Age, gender, and duration of treatment have no significant relation with apical root resorption. Different regions of the mouth encounter varying degrees of apical root resorption. Even in the anterior teeth, incisors are more prone to resorption than canines.


Pastro JDV, Nogueira ACA, Salvatore de Freitas

KM, Valarelli FP, Cançado RH, de Oliveira RCG, et

al. Factors Associated to Apical Root Resorption

after Orthodontic Treatment. Open Dent J.


Dudic A. Influencing Factors of Orthodontic Tooth

Movement and Root Resorption, and Evaluation of

Its Radiographic Diagnostic Means. 2018.

Marques LS, Martins-júnior PA, Ramos-jorge ML,

Paiva SM. Root Resorption in Orthodontics : An

Evidence-Based Approach. 2010.

Agarwal MSS, Chopra CSS, Prasanna C.

ScienceDirect A radiographic study of external

apical root resorption in patients treated with singlephase fixed orthodontic therapy. Med J Armed

Forces India. 2016:1-9.

Olowu TO, Sundararajan A, Moghaddami M, et al.

Open Access Proc J. 2014;2017:1-67.

Preoteasa CT, Ionescu E, Preoteasa E. Risks and

complications associated with orthodontic

treatment. Orthod-Basic Asp Clin Consid.


Tieu LD, Saltaji H, Normando D, Flores-Mir C.

Radiologically determined orthodontically induced

external apical root resorption in incisors after nonsurgical orthodontic treatment of class II division 1

malocclusion: a systematic review. Prog Orthod.


Chávez MGH, Flores AM, Ocampo AM. Apical root

resorption incidence in finished cases of the

Orthodontics Department of the Postgraduate

Studies and Research Division of the Faculty of

Dentistry, UNAM, during the 2010-2012 period.

Rev Mex Ortod. 2015;3(3):e175-e184.

Gay G, Ravera S, Castroflorio T, Garino F, Rossini

G, Parrini S, et al. Root resorption during

orthodontic treatment with Invisalign®: a

radiometric study. Prog Orthod. 2017;18(1):12.

Bellini-Pereira SA, Almeida J, Aliaga-Del Castillo

A, Dos Santos CCO, Henriques JFC, Janson G.

Evaluation of root resorption following orthodontic

intrusion: a systematic review and meta-analysis.

Eur J Orthod. 2021;43(4):432-41.

Linkous ER, Trojan TM, Harris EF. External apical

root resorption and vectors of orthodontic tooth

movement. Am J Orthod Dentofacial Orthop.


Pejicic, A., Bertl, M. & Čelar, A. Extent and

prognosis of apical root resorption due to

orthodontic treatment. J. Stomat. Occ. Med.


Jiang R ping, Mcdonald JP, Fu M kui. Root

resorption before and after orthodontic treatment : a

clinical study of contributory factors. Eur J Orthod.


Topkara A. External apical root resorption caused by

orthodontic treatment : a review of the literature. Int

J Paediatr Dent. 2011;12(3):163-6.

Morford LA, Dempsey J, Mason A, Jacobson E,

Kluemper GT, Macri JV. Genetic and treatmentrelated risk factors associated with external apical

root resorption (EARR) concurrent with orthodontia.

Orthod Craniofac Res. 2015;18(S1):71-82.

Bartzela TN. Apical root resorption after orthodontic

treatment in patients with unilateral cleft lip and

palate. Clin Oral Investig. 2020;24(1):1807-19.

Kalra S, Gupta P, Tripathi T, Rai P. External apical

root resorption in orthodontic patients : molecular

and genetic basis. Int J Paediatr. Dent. 2020;


Masahide Motokawa, Akiko Terao, Masato Kaku,

Toshitsugu Kawata, Carmen Gonzales, M. Ali

Darendeliler, et al. Open bite as a risk factor for

orthodontic root resorption. Eur J Orthod.


Gracemia Vasconcelos Picanço, Karina Maria

Salvatore de Freitas, Rodrigo Hermont Cançado,

Fabricio Pinelli Valarelli, Paulo Roberto Barroso

Picanço, Camila Pontes Feijão. Predisposing factors

to severe external root resorption associated to

orthodontic treatment. Dent Press J Orthod.


Radwan ES, Scribante A, Sfondrini MF, Montasser

MA. Imaging Software Programs for Reliable

Mathematical Measurements in Orthodontics. Dent

J. 2020;8(3):81.

Zasčiurinskienė E, Lund H, Lindsten R, Jansson H,

Bjerklin K. Outcome of orthodontic treatment in

subjects with periodontal disease. Part III: a CBCT

study of external apical root resorption. Eur J

Orthod. 2019;41(6):575-82.

Devlin H, Yuan J. Object position and image

magnification in dental panoramic radiography: a

theoretical analysis. Dentomaxillofac Radiol.


Rondon RHN, Pereira YCL, do Nascimento GC.

Common positioning errors in panoramic

radiography: A review. Imaging Sci Dent.


Apajalahti S, Peltola JS. Apical root resorption after

orthodontic treatment a retrospective study. Eur J

Orthod. 2007;29(4):408-12.

Nanekrungsan K, Patanaporn V, Janhom A,

Korwanich N. External apical root resorption in

maxillary incisors in orthodontic patients: associated

factors and radiographic evaluation. Imaging Sci

Dent. 2012;42(3):147-54.

Thilander B, Rygh P, Reitan K. Tissue reactions in

orthodontics. Orthodontics: current principles and

techniques 5th ed Philadelphia: Elsevier/Mosby.

Jung Y hoa, Cho B hae. External root resorption after

orthodontic treatment : a study of contributing

factors. Imaging Sci Dent. 2011;41(1):17-21.

Dindaroğlu F, Doğan S. Root Resorption in

Orthodontics. Turk J Orthod. 2016: 29(4):103.

Neves BM das, Fernandes LQP, Capelli J. External

apical root resorption after orthodontic treatment:

analysis in different chronological periods. Dent

Press J Orthod. 2022;27(5):1-32.

de Brito LF, Mendes TE, Lima AP, de Almeida

Pedrin RR, Santos CN, Paranhos LR. Influence of

orthodontic treatment on root resorption: a

systematic review. Rev Fac Odontol.-UPF.


Pelagio C, Maués R, Ramos R, Vilella ODV. Severe

root resorption resulting from orthodontic

treatment : Prevalence and risk factors. Dent Press J

Orthod. 2015;20(1):52-8.

Futyma-Gąbka K, Różylo-Kalinowska I, Piskórz

M, Bis E, Borek W. Evaluation of root resorption in

maxillary anterior teeth during orthodontic treatment

with a fixed appliance based on panoramic

radiographs. Pol J Radiol. 2022;87(1):545-8.

Belinda W, Katherine W.L. Vig, Henry W. Fields,

Shiva Shanker, Eloise E. Kaizar. Root resorption

associated with orthodontic tooth movement: a

systematic review. Am J Orthod Dentofac Orthop.


Yassir YA, McIntyre GT, Bearn DR. Orthodontic

treatment and root resorption: an overview of

systematic reviews. Eur J Orthod. 2021;43(4):442-

Zahrowski J, Jeske A. Apical root resorption is

associated with comprehensive orthodontic

treatment but not clearly dependent on prior tooth

characteristics or orthodontic techniques. J Am Dent

Assoc. 2011;142(1):66-8.

Makedonas D, Lund H, Hansen K. Root resorption

diagnosed with cone beam computed tomography

after 6 months and at the end of orthodontic

treatment with fixed appliances. Angle Orthod.


Bayir F, Gumus EB. External apical root resorption

after orthodontic treatment: Incidence, severity and

risk factors. J Dent Res Dent Clin Dent Prospects.


Sameshima GT, Sinclair PM. Predicting and

preventing root resorption: Part I. Diagnostic factors.

Am J Orthod Dentofa Orthop. 2001;119(5):505-10.

Monika Tymczyna -Sobotka, Monika Mikulska,

Gabriela Baran. Resorption as a complication of

overlay orthodontic treatment: a literature review.

Research Square.2022.

Årtun J, Van’t Hullenaar R, Doppel D, KuijpersJagtman AM. Identification of orthodontic patients

at risk of severe apical root resorption. Am J Orthod

Dentofac Orthop. 2009;135(4):448-55.



How to Cite

The Prevalence of Root Resorption in a Sample of Orthodontic Patients Treated in Private Clinics in Sulaimani City/ A Retrospective Study. (2024). Sulaimani Dental Journal, 11(1), 12.

Most read articles by the same author(s)