PMC8716209_01
(a-d) Pretreatment intraoral photographs.
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This was further complicated by increased overjet of 11 mm, hyperdivergent jaw bases with anterior open bite by 1 mm, narrow arches, palatally erupted #14, upper dental midline shift towards the right, cuspal class II relation on the right and full tooth class II on the left side, class II division 1 incisor relation, and circum-oral muscular hyperactivity on swallow (Figures 1(a)-1(d)).
(a) Pretreatment OPG and (b) lateral cephalogram tracing with values.
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Gendex Dental Systems, 901 W Oakton St., Des Plaines IL 60018-184) revealed certain teeth with pipette-shaped, pointed apical third root contours with few others dilacerated and rectangular morphology. Generalized horizontal bone loss was also identified in the upper and lower posterior regions (Figure 2(a)). The maxillary dentition had a neutral compensation with protrusion, while the mandibular teeth had unfavorable compensation with both inclination and protrusion which were measured using online WebCeph software application (Figure 2(b)).
Midtreatment OPG showing OIEARR varying from moderate to severe in maxillary teeth and mild in mandibular teeth.
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The OPG and (IOPAR) revealed multiple teeth root resorption both in the maxillary anterior and posterior teeth as well as in certain mandibular teeth (Figure 3) after 26 months of initiation, compromising further treatment and discontinuation of all other planned procedures.
Intraoral periapical radiographs of (a) maxillary incisors, (b) maxillary left posterior teeth, and (c) mandibular right posterior teeth showing severe OIEARR.
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The most affected were maxillary incisors and premolars around 4 mm followed by canines, molars (Figure 4), and the least being mandibular teeth ranging from 0 to 3 mm, as no major mechanics was involved.
(a-e) Midtreatment intraoral photographs.
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Clinically, the intraoral picture was healthy and absolutely without any signs of root resorption (Figure 5) which was occurring within the periodontium.