Root Resorption in Mandibular Incisors During Orthodontic Treatment with Invisalign®: A Radiometric Study

Existing literature indicates that orthodontics patients are more likely to have severe apical root shortening, interesting mostly maxillary, followed by mandibular incisors.
The aim of the present study was to investigate the incidence and severity of root resorption (RR) in mandibular incisors of adult patients treated with aligners.
The study group consisted of 71 adult healthy patients (mean age 32.8 ± 12.7) treated with aligners (Invisalign®, Align Technologies, San Jose, CA, USA) for the intrusion of the lower incisors. Root and crown lengths of a total of 279 lower incisors were measured in panoramic radiographs at the beginning (T0) and at the end (T1) of aligner therapy. Individual root-crown-ratio (RCR) of each tooth and therefore the relative changes of RCR (rRCR) were determined.
44% of the 279 measured teeth presented a reduction of the pre-treatment root length. A reduction in percentage of > 0% up to 10% was found in 26.76% (n = 76), a distinct reduction of > 10% up to 20% in 12.32% (n = 35) of the sample. 4.58% (n = 13) of the teeth were affected by a clinically relevant reduction (> 20%).
Orthodontic treatment with Invisalign® aligners could led to RR in cases in which intrusion of the lower incisors is planned. However, the incidence of RR is comparable to data described in case of application of light forces with fixed appliances, and considerably lower than what has been described for traditional comprehensive orthodontic treatments.