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Medical Forum / General / Dentistry / December 2006Risk of root adsorption for adult orthodontal work
Hi there, Just joined the group and just want to get some second opinions out in cyberspace. I am a 30 year old male who just completed full mouth periondontal work (rooting/scaling, bone graft, emdogain... the whole deal...) . The perodontist suggested me to see an orthodontist for some minor adjustment to correct some cross byte in my back molars and over byte in the front teeth. Today I wend to see the orthodontist, and was told the treatment would involve wearing braces over a 20 month span, involves taking out two top wisdom teeth and third molars. When asked about how long it would take to close the spacing as result of third molar extraction, was told about 9 month. However any serious complications, such as serious root adsorption, would cause a premature termination of the procedure and incomplete closing of the spacing, a partial refund would be given in such cases. Gee, a partial refund isn't that comforting knowing I will be at risk of ending up with two spacing in my teeth if anything goes wrong. I guess the question is: 1. has anyone undergone orthodontal treatment and have to stop treatment due to root adsorption? 2. is root adsorption common with orthodontal treatment. or is it a rare event? I am quite concerned about this and thinking about just having the wisdom teeth pulled and asking the orthodontist to stay away from my third molar, but according to him that would actually make the overbyte more difficult to treat. Any comments will be highly appreciated !! > Hi there, > [quoted text clipped - 29 lines] > > Any comments will be highly appreciated !! Frankly, this sounds like a more or less boilerplate informed consent to orthodontic treatment. It does happen, but frankly I've rarely seen in in my adult patients who've had ortho treatment (I do no ortho myself). Mostly (far more frequently when I was starting out) I saw blunted roots on patients who had had orthodontic treatment in childhood, while root formation was still taking place. Most orthodontists now are very judicious in force application, and I seldom see this in my younger patients anymore. I'm not sure about the spacing you speak of. Third molars ARE the wisdom teeth--ordinarily the last teeth in the arch. So extraction of third molars do not generally cause the other teeth to drift (although they may in seriously periodontally-involved mouths). If there are spaces now you should discuss now how retention is going to be accomplished--that is, how is the orthodontist going to prevent drifting after the orthodontic appliances are removed. In children often removable retainers are worn at night, but in periodontally-involved adult mouths frequently some form of fixed retention device may be advisable. Perhaps Carabelli will comment. Steve Thanks Steven for your helpful message, so it sounds like as long as the orthodontist is very judicious about applying the forces, root resorption can be prevented or minimized correct? I have stressed strongly to the orthodontist regarding my periodontal problem, and he also agrees any teeth movement will be very conservative. I would hope as long as we take one small step at a time in moving the teeth I should be okay? Also do orthodontists generally take a set of pano x-rays everytime the teeth is adjusted to measure stuff like root resorption, periodontal issues and other issues? Your comments are highly appreciated ! > Thanks Steven for your helpful message, so it sounds like as long as > the orthodontist is very judicious about applying the forces, root [quoted text clipped - 9 lines] > > Your comments are highly appreciated ! The risk is quite small. No, I doubt pans would be taken for every adjustment, though post treatment films might be taken. Intraoral films are better at detecting root resorption, and if there are any concerns either the orthodontist or your general dentist can take x-rays as need is perceived. But I wouldn't stress out on this--really. Happy New Year, Steve Thank you, I am seeing a dentist for extraction next week followed by braces placement the week after, I will try not to stress out about it too much, thanks for the advice.
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