Orthodontic Root Resorption — ORE Part 1 MCQ

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HardOrthodonticsOrthodontic Root ResorptionORE Part 1

Six months after active fixed-appliance treatment begins, a periapical radiograph shows new external apical root resorption affecting the maxillary incisors. What is the most appropriate next step?

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Correct answer: A — Interrupt active mechanics for 2–3 months and review radiographically

Explanation lettering: D = shown as B · E = shown as D · B = shown as E

A is correct. Once new external apical root resorption is identified during fixed-appliance treatment, active mechanics should be interrupted for 2–3 months and the roots reviewed radiographically. A directly relevant clinical study found less subsequent resorption with this interruption than with uninterrupted treatment. Permanent termination is not automatically necessary: subsequent management depends on the extent of resorption, progression and treatment objectives. Continuing mechanics without change risks further injury. Increasing force is inappropriate, as heavier forces may increase resorption risk. Changing to a removable appliance while maintaining active forces does not remove the mechanical stimulus or provide the therapeutic rest period. The key action is cessation of active force, followed by reassessment.

Reference: Levander E, Malmgren O, Eliasson S. Evaluation of root resorption in relation to two orthodontic treatment regimes: a clinical experimental study. European Journal of Orthodontics. 1994;16(3):223–228. https://pubmed.ncbi.nlm.nih.gov/8062862/