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Tuesday, May 21, 2013
Braces After Dental Injury - Root Absorption
A year ago, when my son was nine, he was hit in the mouth with a metal baseball bat. This knocked out baby tooth #11 and broke off two upper (8,9) and three lower (23,24,25) teeth. His teeth were also shoved back and to the right. The next day his teeth were manipulated to a more normal position. Since that time my son has had three root canals and a lot of dental bonding. At this point, he has lost all but two of his baby teeth, one of which is quite loose, and his 12 year molars have erupted. The space where his tooth was knocked out is closing and there is not enough room to accomodate tooth #11. We have consulted with an orthodontist who feels my son should have braces applied fairly quickly. I am scared to proceed because I do not want to create any additional dental problems. I am mainly concerned about the possibility of root absorption. His front teeth are being monitered by an endodontist, and there is a strong possibility that he will need additional root canal therapy. Is he more likely to experience root absorption if braces are applied due to the injuries he has had, and is he more likely to have problems with the teeth that have already received root canals? The injury really messed up his teeth, and I think he would probably smile again if his teeth were straightened. I just don`t want to create additional problems. He has been through enough already. Also, if we have the braces applied, and he does experience some root absorption, will root canal therapy stop the absorption? I am scared he will end up loosing his front teeth. I appreciate any insight you can give on the subject.
" Is he more likely to experience root absorption if braces are applied due to the injuries he has had?" Yes, dental trauma is a significant risk factor for root resorption.
"And is he more likely to have problems with the teeth that have already received root canals?" Studies show that root canal treated teeth are the same as non-root canal treated teeth in terms of tooth movement and root resorption.
"Also, if we have the braces applied, and he does experience some root absorption, will root canal therapy stop the absorption? " No. The only way to stop the resorption is to stop moving the teeth.
One important fact to remember is that no patient has ever spontaneously lost a tooth due to orthodontic root resorption. Teeth with resorbed roots can get loose, but they do not just fall out.
Mark G Hans, DDS, MSD
Professor of Orthodontics
School of Dental Medicine
Case Western Reserve University