Int J Stomatol

Int J Stomatol ›› 2026, Vol. 53 ›› Issue (6): 945-954.doi: 10.7518/gjkq.2026227

• Review • Previous Articles    

Research progress and intervention strategies in the prevention and treatment of orthodontically induced root resorption

Shuxian Yang(),Peipei Duan()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2025-07-26 Revised:2025-09-02 Online:2026-11-01 Published:2026-10-29
  • Contact: Peipei Duan E-mail:yangsx0319@163.com;duanp@scu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(82471020);Sichuan Science and Technology Program(2024NSFSC1593);University-Industry Collaborative Education Program, Department of Higher Education, the Ministry of Education(the second batch in 2020)

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Abstract:

Orthodontically induced root resorption (OIRR) is a common complication during orthodontic treatment, with a complex pathogenesis involving individual patient differences and multiple treatment-related factors. Root resorption may affect the long-term health and treatment prognosis of teeth. Consequently, numerous studies have been conduc-ted to explore strategies for its prevention and management, aiming not only to mitigate resorption but also to develop intelligent prevention and control systems. This article reviews the research progress of current major treatment methods, including pharmacotherapy, low-intensity pulsed ultrasound, photobiomodulation therapy, and artificial-intelligence-based prediction, with the aim of providing a theoretical foundation and practical insights for refining intervention strategies and ultimately contributing to the development of safer and more effective therapeutic approaches.

Key words: orthodontically induced root resorption, drug therapies, low-intensity pulsed ultrasound, photobiomo-dulation therapy

CLC Number: 

  • R783.5

TrendMD: 

Tab 1

Treatment regimens and outcomes of different medications in reducing OIRR"

药物名称动物种类药物剂量给药时长给药方式正畸牙移动距离牙根吸收
表没食子儿茶素没食子酸酯[9]Wistar大鼠每天50或100 mg/kg14 d灌胃减小减小
青藤碱[10]Wistar大鼠每天20或 40 mg/kg14 d腹腔注射减小减小
雷公藤甲素[11]Wistar大鼠每天15或 30 μg/kg14 d腹腔注射减小减小
淫羊藿苷[12]Wistar大鼠每天2.5 mg/kg21 d灌胃未涉及减小
白藜芦醇[13]Wistar大鼠每天5或10 mg/kg14 d灌胃减小减小
黄芩苷[14]Wistar大鼠每2天250 mg/kg21 d腹腔注射无明显变化减小
达沙替尼+槲皮素[3]Wistar大鼠每周6.67 mg/kg达沙替尼、66.7 mg/kg槲皮素8 d或14 d灌胃减小减小
对乙酰氨基酚[17]Wistar大鼠每天10?mg/kg30 d灌胃无明显变化减小
洛索洛芬[18]Wistar大鼠每天1 mg/kg30 d灌胃无明显变化减小
美洛昔康[19]Fischer344 大鼠每天3 mg/kg25 d灌胃减小减小
阿仑膦酸钠[22]山羊每次1 mL126 d牙周膜注射未涉及减小
雷尼酸锶[23]Wistar大鼠每天900 mg/kg28 d灌胃减少减少
甲状旁腺激素[33]Wistar大鼠每天40 μg/kg7、14、28 d皮下注射未涉及减小
雌二醇[36]Wistar大鼠每天10 μg/kg7、14、28 d皮下注射未涉及减小

Fig 1

Multiple drugs reduce OIRR through the OPG/RANKL/RANK pathway"

[1] Li YN, Jacox LA, Little SH, et al. Orthodontic tooth movement: the biology and clinical implications[J]. Kaohsiung J Med Sci, 2018, 34(4): 207-214.
[2] Patel S, Saberi N, Pimental T, et al. Present status and future directions: root resorption[J]. Int Endod J, 2022, 55(): 892-921.
[3] Zhou Y, Nishiura A, Morikuni H, et al. RANKL+ senescent cells under mechanical stress: a therapeutic target for orthodontic root resorption using senoly-tics[J]. Int J Oral Sci, 2023, 15(1): 20.
[4] Kalra S, Gupta P, Tripathi T, et al. External apical root resorption in orthodontic patients: molecular and genetic basis[J]. J Family Med Prim Care, 2020, 9(8): 3872-3882.
[5] Toyokawa-Sperandio KC, Conti ACCF, Fernandes TMF, et al. External apical root resorption 6 months after initiation of orthodontic treatment: a rando-mized clinical trial comparing fixed appliances and orthodontic aligners[J]. Korean J Orthod, 2021, 51(5): 329-336.
[6] Sameshima GT, Iglesias-Linares A. Orthodontic root resorption[J]. J World Fed Orthod, 2021, 10(4): 135-143.
[7] Sondeijker CFW, Lamberts AA, Beckmann SH, et al. Development of a clinical practice guideline for orthodontically induced external apical root resorption[J]. Eur J Orthod, 2020, 42(2): 115-124.
[8] van Doornik SP, Pijnenburg MBM, Janssen KI, et al. Evaluation of the use of a clinical practice guideline for external apical root resorption among orthodontists[J]. Prog Orthod, 2024, 25(1): 15.
[9] Zou JH, Chen F, Li YL, et al. Effects of green tea extract epigallocatechin-3-gallate (EGCG) on or-thodontic tooth movement and root resorption in rats[J]. Arch Oral Biol, 2023, 150: 105691.
[10] Li HK, Li YL, Zou JH, et al. Sinomenine inhibits orthodontic tooth movement and root resorption in rats and enhances osteogenic differentiation of PDLSCs[J]. Drug Des Devel Ther, 2022, 16: 2949-2965.
[11] Yang F, Wang XX, Ma D, et al. Effects of triptolide on tooth movement and root resorption in rats[J]. Drug Des Devel Ther, 2019, 13: 3963-3975.
[12] Wang F, Liu ZF, Lin SS, et al. Icariin enhances the healing of rapid palatal expansion induced root resorption in rats[J]. Phytomedicine, 2012, 19(11): 1035-1041.
[13] Liu XC, Wang XX, Zhang LN, et al. Inhibitory effects of resveratrol on orthodontic tooth movement and associated root resorption in rats[J]. Arch Oral Biol, 2020, 111: 104642.
[14] Kunimatsu R, Kimura A, Tsuka Y, et al. Baicalin inhibits root resorption during tooth movement in a rodent model[J]. Arch Oral Biol, 2020, 116: 104770.
[15] Farr JN, Xu M, Weivoda MM, et al. Targeting cellular senescence prevents age-related bone loss in mice[J]. Nat Med, 2017, 23(9): 1072-1079.
[16] Colceriu-Șimon IM, Feștilă D, Emoke H, et al. The effects of non-steroidal anti-inflammatory drugs used for orthodontic pain management on tooth movement: a comprehensive review of the literature[J]. J Clin Med, 2025, 14(9): 2920.
[17] Kaku M, Yamamoto T, Yashima Y, et al. Acetaminophen reduces apical root resorption during orthodontic tooth movement in rats[J]. Arch Oral Biol, 2019, 102: 83-92.
[18] Yamamoto T, Kaku M, Sumi H, et al. Effects of loxoprofen on the apical root resorption during or-thodontic tooth movement in rats[J]. PLoS One, 2018, 13(4): e0194453.
[19] Kirschneck C, Meier M, Bauer K, et al. Meloxicam medication reduces orthodontically induced dental root resorption and tooth movement velocity: a combined in vivo and in vitro study of dental-periodontal cells and tissue[J]. Cell Tissue Res, 2017, 368(1): 61-78.
[20] Gameiro GH, Nouer DF, Pereira-Neto JS, et al. Histological analysis of orthodontic root resorption in rats treated with the cyclooxygenase-2 (COX-2) inhibitor celecoxib[J]. Orthod Craniofac Res, 2008, 11(3): 156-161.
[21] Kuźnik A, Październiok-Holewa A, Jewula P, et al. Bisphosphonates-much more than only drugs for bone diseases[J]. Eur J Pharmacol, 2020, 866: 172773.
[22] Tokhtah HA, Alhadlaq AM. Utility of injectable bisphosphonates in enhancing orthodontic retention in a goat model: a split-mouth study[J]. Saudi Dent J, 2022, 34(4): 282-287.
[23] Kirschneck C, Wolf M, Reicheneder C, et al. Strontium ranelate improved tooth anchorage and reduced root resorption in orthodontic treatment of rats[J]. Eur J Pharmacol, 2014, 744: 67-75.
[24] Sirisoontorn I, Hotokezaka H, Hashimoto M, et al. Orthodontic tooth movement and root resorption in ovariectomized rats treated by systemic administration of zoledronic acid[J]. Am J Orthod Dentofacial Orthop, 2012, 141(5): 563-573.
[25] Wei XX, Chu JP, Zou YZ, et al. Effect of odanacatib on root resorption and alveolar bone metabolism during orthodontic tooth movement[J]. Genet Mol Res, 2015, 14(4): 17972-17981.
[26] Zymperdikas VF, Yavropoulou MP, Kaklamanos EG, et al. Effects of systematic bisphosphonate use in patients under orthodontic treatment: a systematic review[J]. Eur J Orthod, 2020, 42(1): 60-71.
[27] Sarango-Quishpe KT, Cabrera-Padrón MI, Torracchi-Carrasco JE, et al. Effect of bisphosphonate vs. osteoprotegerin during orthodontic tooth movement: a systematic review and meta-analysis[J]. Korean J Orthod, 2025, 55(2): 120-130.
[28] Wilka L, Vallejo GB, Miranda F, et al. Orthodontics and bisphosphonates: risks, limitations, and consi-derations: a narrative review[J]. Semin Orthod, 2025, 31(4): 544-550.
[29] Smit MA, van Kinschot CMJ, van der Linden J, et al. Clinical guidelines and PTH measurement: does assay generation matter[J]. Endocr Rev, 2019, 40(6): 1468-1480.
[30] Aspenberg P, Genant HK, Johansson T, et al. Teriparatide for acceleration of fracture repair in humans: a prospective, randomized, double-blind study of 102 postmenopausal women with distal radial fractures[J]. J Bone Miner Res, 2010, 25(2): 404-414.
[31] Vasconcelos DF, Marques MR, Benatti BB, et al. Intermittent parathyroid hormone administration improves periodontal healing in rats[J]. J Periodontol, 2014, 85(5): 721-728.
[32] 宿晨曦, 张程, 何姝姝, 等. 特立帕肽对骨质疏松大鼠正畸牙移动中牙根吸收影响的micro-CT研究[J]. 口腔医学研究, 2024, 40(2): 136-141.
Su CX, Zhang C, He SS, et al. Effect of teriparatide on root resorption during orthodontic tooth movement in ovariectomized rats by micro-CT[J]. J Oral Sci Res, 2024, 40(2): 136-141.
[33] Li TC, Wang H, Lv CX, et al. Intermittent parathyroid hormone promotes cementogenesis via ephrinB2-EPHB4 forward signaling[J]. J Cell Physiol, 2021, 236(3): 2070-2086.
[34] Li TC, Wang H, Jiang YK, et al. LITTIP/Lgr6/HnRNPK complex regulates cementogenesis via Wnt signaling[J]. Int J Oral Sci, 2023, 15(1): 33.
[35] Amaro ERS, Ortiz FR, Dorneles LS, et al. Estrogen protects dental roots from orthodontic-induced inflammatory resorption[J]. Arch Oral Biol, 2020, 117: 104820.
[36] Li TC, Zhou ZY, Wang H, et al. Effects of estrogen on root repair after orthodontically induced root resorption in ovariectomized rats[J]. Am J Orthod Dentofacial Orthop, 2020, 158(2): 247-263.e1.
[37] Rego EB, Takata T, Tanne K, et al. Current status of low intensity pulsed ultrasound for dental purposes[J]. Open Dent J, 2012, 6: 220-225.
[38] Vaddamanu SK, Alhamoudi FH, Vyas R, et al. Attenuation of orthodontically induced inflammatory root resorption by using low-intensity pulsed ultrasound as a therapeutic modality—a systematic review[J]. BMC Oral Health, 2024, 24(1): 67.
[39] Zhao YF, Su Q, Zhang B, et al. Efficacy of low-intensity pulsed ultrasound in orthodontic tooth movement and orthodontically induced root resorption in animal and human studies: a systematic review and meta-analysis[J]. Clin Oral Investig, 2024, 29(1): 6.
[40] Dalla-Bona DA, Tanaka E, Inubushi T, et al. Cementoblast response to low- and high-intensity ultrasound[J]. Arch Oral Biol, 2008, 53(4): 318-323.
[41] Inubushi T, Tanaka E, Rego EB, et al. Ultrasound stimulation attenuates resorption of tooth root induced by experimental force application[J]. Bone, 2013, 53(2): 497-506.
[42] Zheng F, Wu T, Wang FF, et al. Low-intensity pulsed ultrasound promotes the osteogenesis of mechanical force-treated periodontal ligament cells via Piezo1[J]. Front Bioeng Biotechnol, 2024, 12: 1347406.
[43] Wu T, Zheng F, Tang HY, et al. Low-intensity pulsed ultrasound reduces alveolar bone resorption during orthodontic treatment via Lamin A/C-Yes-associated protein axis in stem cells[J]. World J Stem Cells, 2024, 16(3): 267-286.
[44] Zheng F, Wu T, Wang FF, et al. Effect of low-intensity pulsed ultrasound on the mineralization of force-treated cementoblasts and orthodontically induced inflammatory root resorption via the Lamin A/C-Yes associated protein axis[J]. J Periodontal Res, 2025, 60(2): 189-199.
[45] Dahhas FY, El-Bialy T, Afify AR, et al. Effects of low-intensity pulsed ultrasound on orthodontic tooth movement and orthodontically induced inflammatory root resorption in ovariectomized osteoporotic rats[J]. Ultrasound Med Biol, 2016, 42(3): 808-814.
[46] El-Bialy T, Farouk K, Carlyle TD, et al. Effect of low intensity pulsed ultrasound (LIPUS) on tooth movement and root resorption: a prospective multi-center randomized controlled trial[J]. J Clin Med, 2020, 9(3): 804.
[47] Adly MS, Adly AS, Younes R, et al. Prevention and repair of orthodontically induced root resorption u-sing ultrasound: a scoping review[J]. Expert Rev Med Devices, 2023, 20(8): 633-642.
[48] Kong L, Hou J, Zhao Y. The preventive and rehabilitative effects of photobiomodulation on orthodontically induced root resorption: a systematic review of animal studies[J]. Photobiomodul Photomed Laser Surg, 2025, 43(8): 323-336.
[49] Ozturk T, Gul Amuk N. Effects of photobiomodulation at different wavelengths on orthodontically induced root resorption in orthodontic retention pe-riod: a micro-CT and RT-PCR study[J]. Lasers Med Sci, 2020, 35(6): 1419-1429.
[50] de Melo Conti C, Suzuki H, Garcez AS, et al. Effects of photobiomodulation on root resorption induced by orthodontic tooth movement and RANKL/OPG expression in rats[J]. Photochem Photobiol, 2019, 95(5): 1249-1257.
[51] Nayyer N, Tripathi T, Rai P, et al. Effect of photobio-modulation on external root resorption during or-thodontic tooth movement—a randomized controlled trial[J]. Int Orthod, 2021, 19(2): 197-206.
[52] Nayyer N, Tripathi T, Ganesh G, et al. Impact of photobiomodulation on external root resorption du-ring orthodontic tooth movement in humans—a systematic review and meta-analysis[J]. J Oral Biol Craniofac Res, 2022, 12(4): 469-480.
[53] Ang Khaw CM, Dalci O, Foley M, et al. Physical properties of root cementum: part 27. Effect of low-level laser therapy on the repair of orthodontically induced inflammatory root resorption: a double-blind, split-mouth, randomized controlled clinical trial[J]. Am J Orthod Dentofacial Orthop, 2018, 154(3): 326-336.
[54] Ng D, Chan AK, Papadopoulou AK, et al. The effect of low-level laser therapy on orthodontically induced root resorption: a pilot double blind rando-mized controlled trial[J]. Eur J Orthod, 2018, 40(3): 317-325.
[55] Michelogiannakis D, Al-Shammery D, Akram Z, et al. Influence of low-level laser therapy on orthodontically-induced inflammatory root resorption. A systematic review[J]. Arch Oral Biol, 2019, 100: 1-13.
[56] Hu YJ, Liu WT, Liu ZJ, et al. Receptor activator of nuclear factor-kappa ligand, OPG, and IGF-Ⅰ expression during orthodontically induced inflammatory root resorption in the recombinant human growth hormone-treated rats[J]. Angle Orthod, 2015, 85(4): 562-569.
[57] Hakami Z, Kitaura H, Kimura K, et al. Effect of interleukin-4 on orthodontic tooth movement and associated root resorption[J]. Eur J Orthod, 2015, 37(1): 87-94.
[58] Yoshimatsu M, Kitaura H, Fujimura Y, et al. Inhibitory effects of IL-12 on experimental tooth movement and root resorption in mice[J]. Arch Oral Biol, 2012, 57(1): 36-43.
[59] Ueda-Ichinose Y, Hotokezaka H, Miyazaki T, et al. Lithium reduces orthodontically induced root resorption by suppressing cell death, hyalinization, and odontoclast formation in rats[J]. Angle Orthod, 2022, 92(4): 547-554.
[60] Funaki-Dohi M, Hotokezaka Y, Hotokezaka H, et al. Importance of the early phase of orthodontic force application in the induction of root resorption[J]. Angle Orthod, 2025, 95(3): 323-331.
[61] Gonzales C, Hotokezaka H, Karadeniz EI, et al. Effects of fluoride intake on orthodontic tooth movement and orthodontically induced root resorption[J]. Am J Orthod Dentofacial Orthop, 2011, 139(2): 196-205.
[62] Qi JW, Kitaura H, Shen WR, et al. Effect of a DPP-4 inhibitor on orthodontic tooth movement and associated root resorption[J]. Biomed Res Int, 2020, 2020: 7189084.
[63] Hu Q, Zhou JP, Xu XL, et al. Effect of EMD on the orthodontically induced root resorption repair process in rats[J]. J Orofac Orthop, 2018, 79(2): 83-95.
[64] Amuk NG, Kurt G, Baran Y, et al. Effects of cell-mediated osteoprotegerin gene transfer and mesenchymal stem cell applications on orthodontically induced root resorption of rat teeth[J]. Eur J Orthod, 2017, 39(3): 235-242.
[65] Amuk NG, Kurt G, Karsli E, et al. Effects of mesenchymal stem cell transfer on orthodontically induced root resorption and orthodontic tooth movement during orthodontic arch expansion protocols: an experimental study in rats[J]. Eur J Orthod, 2020, 42(3): 305-316.
[66] Yuan WX, Huang MT, Chen WQ, et al. Reduced graphene oxide loaded with tetrahedral framework nucleic acids for combating orthodontically induced root resorption[J]. J Nanobiotechnology, 2024, 22(1): 700.
[67] Nashiro-Oyakawa Y, Hotokezaka Y, Hotokezaka H, et al. Inhibition of 12/15-lipoxygenase reduces orthodontically induced root resorption in rats[J]. Angle Orthod, 2024, 94(5): 566-573.
[68] Fiolita SV, Aini Rasyid FQ, Nurhalifah L, et al. Forastero cacao bean extract gel decreases IL-6 positive osteoblasts, osteoclasts, and osteocytes on OIRR model: a primitive study[J]. J Taibah Univ Med Sci, 2025, 20(2): 129-138.
[69] Mo LJ, Zhu JQ, Li MY, et al. Smads and AP-1 activation of TGF-β signaling upregulate transcription of osteoprotegerin in cementoblasts to inhibit osteoclastogenesis[J]. FASEB J, 2024, 38(22): e70171.
[70] Zheng QH, Ma L, Wu YJ, et al. Automatic 3-dimensional quantification of orthodontically induced root resorption in cone-beam computed tomography i-mages based on deep learning[J]. Am J Orthod Dentofacial Orthop, 2025, 167(2): 188-201.
[71] 左志刚, 付甜甜, 李馨兰, 等. 基于锥形束CT影像组学与临床特征的上颌切牙中重度正畸诱导炎症性牙根吸收风险预测模型的构建[J]. 中华口腔医学杂志, 2025, 60(5): 509-517.
Zuo ZG, Fu TT, Li XL, et al. Construction of a risk prediction model for moderate to severe orthodontic-induced inflammatory root resorption of maxillary incisors based on cone beam CT radiomics and clinical features[J]. Chin J Stomatol, 2025, 60(5): 509-517.
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