Orthodontically induced external apical root resorption and demineralized lesions: Clinical considerations in orthodontic finishing

作者：Mette A.R. Kuijpers, Sebastiaan P. van Doornik, Anne Marie Kuijpers‐Jagtman · 发表于：Seminars in Orthodontics · 年份：2025 · DOI：10.1053/j.sodo.2025.10.010 · 研究领域：Orthodontics and Dentofacial Orthopedics、dental development and anomalies、Oral and Maxillofacial Pathology

Orthodontic treatment, despite its many benefits, is not without adverse effects. These effects, including orthodontically induced external apical root resorption (EARR) and enamel demineralization in the form of demineralized lesions (DLs), the so-called white spots, often become apparent during or after treatment. Optimal enamel health and minimization of root resorption are essential finishing goals in any orthodontic treatment plan, irrespective of technique or treatment philosophy. This narrative review showed that prevention of EARR remains highly challenging. Increasing evidence suggests that genetic predisposition plays a decisive role in EARR susceptibility. At present, however, no effective clinical strategies are available to modify these genetic risk factors. In contrast, the development of DLs revolves around prevention. A strict preventive protocol should be implemented for every orthodontic patient. Nonetheless, patient adherence to preventive measures remains suboptimal. The process of developing clinical practice guidelines (CPGs) has highlighted critical gaps in our current understanding—regarding both EARR and DLs. For EARR, there is a lack of reliable data on risk factors and predictive indicators. In the context of DLs, important knowledge deficits remain in long-term risk prediction, cost-effectiveness of preventive interventions, patient-reported outcomes, and treatment-specific guidelines for clear aligner treatment. These gaps should be addressed in f...