ABSTRACT Orthodontically induced inflammatory root resorption (OIIRR) is one of the most frequently reported biological side effects of orthodontic treatment. It represents an irreversible loss of cementum and dentin caused by sterile inflammation in the periodontal ligament (PDL) under mechanical stress. While most patients experience only minor apical shortening with negligible consequences, a small subset develops severe external apical root resorption, which can compromise tooth longevity and alter treatment outcomes. The pathogenesis of OIIRR involves compression of the PDL, vascular changes, release of inflammatory mediators, activation of clastic cells, and genetic susceptibility. Epidemiological studies suggest that while nearly all orthodontic patients exhibit some radiographic signs of resorption, only 1%–5% develop clinically severe lesions. Predisposing factors include root morphology, history of trauma, genetic polymorphisms, treatment duration, and certain biomechanics such as intrusion and torque. Diagnostic approaches rely on periapical radiographs and increasingly on cone-beam computed tomography, although radiation dose limits its routine use. Prevention involves individualized force application, shortened treatment times, and special care in high-risk patients. Management depends on severity, ranging from observation to treatment modification or termination. This review synthesizes current evidence on the biology, prevalence, risk factors, diagnosis, prevention, and management of OIIRR and highlights future directions in genetics, biomarkers, and artificial intelligence.
Sapna et al. (Tue,) studied this question.