Orthodontic Patient Suffers Root Resorption From Tight Braces

This case involves a 14-year-old male from Minnesota who had orthodontic treatment for two and a half years. For the first year of the patient’s treatment, everything appeared normal with his progress. After the first year, however, the patient began exhibiting signs of root resorption. The patient sought a second opinion from another orthodontist. X-rays were taken and the new orthodontist confirmed that the roots of 9 teeth had been irreparably damaged. The new orthodontist also forecasted that the patient would lose some or all of the affected teeth within the next 5-10 years. It was alleged that the first orthodontist tightened the patient’s braces too quickly over a short period of time, causing root resorption.

Question(s) For Expert Witness

1. How often do you perform orthodontic manipulations like the one described in this case?

2. Under what circumstances could tightening braces cause root resorption?

3. How would you determine the likelihood that a patient would lose their teeth?

Expert Witness Response E-018938

I perform orthodontic manipulations routinely at both my university and hospital practice. Resorption is by far the most common reason why orthodontists get sued. Root resorption can occur at any time during orthodontic therapy, especially when excessive forces might be applied during manipulations. The likelihood that a patient would lose their teeth could be determined by examining the amount of root length left after the resorption occurs and the general dental health of the supporting bone around those teeth.