Original Article

Rapid maxillary expansion: Do banded teeth develop more external root

resorption than non-banded anchorage teeth?
Debora C. Martinsa; Bernardo Q. Soukib; Paula L. Cheiba; Gerluza A.B. Silvac; Igor D.G. Reisd;
Dauro D. Oliveirab; Eduardo Nunese

ABSTRACT
Objective: To compare external root resorption (ERR) when bands and wires are used as
orthodontic anchorage during rapid maxillary expansion (RME).
Materials and Methods: Histologic analysis was performed on 108 sites from 18 maxillary first
premolars and on 36 sites from six mandibular first premolars in nine subjects (mean age 5 15.2 6
1.4 years) 3 months after RME. Maxillary teeth were pooled into two groups (n 5 54 each)
according to the type of orthodontic anchorage (band group [BG] vs wire group [WG]). Anchorage
type was randomly chosen in a split-mouth design. Mandibular first premolars, which were not
subjected to orthodontic forces, were used as the control group (CG).
Results: All premolars in the BG and WG showed ERR at the level of the cementum and dentin.
Repair with cementum cells was observed in all resorption areas, but complete repair was rarely
found. No statistically significant difference was found between the BG and WG with regard to the
ERR. No association was found between the root height position (middle or cervical third) and the
incidence of ERR. Buccal root surfaces showed a higher amount of ERR compared with the palatal
and interproximal surfaces. ERR was not found in any teeth in the CG.
Conclusion: All maxillary first premolars subjected to RME showed ERR and partial cementum
repair. Banded teeth did not develop more ERR than nonbanded anchorage teeth. (Angle Orthod.
2016;86:3945.)
KEY WORDS: Histology; Rapid maxillary expansion; Root resorption

a
Currently serving the Brazilian Army Dental Service,
Manaus, Brazil; Former Orthodontic Resident, Graduate Pro-
gram in Dentistry, Pontifical Catholic University of Minas Gerais,
Belo Horizonte, Brazil.
b
Associate Professor of Orthodontics, Graduate Program in
Orthodontics, Pontifical Catholic University of Minas Gerais,
Belo Horizonte, Brazil.
c
Associate Professor of Histology, Department of Morpholo-
gy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
d
Biomedicine undergraduate student, Department of Mor-
phology, Federal University of Minas Gerais, Belo Horizonte,
Brazil.
e
Associate Professor of Endodontics, Graduate Program in
Dentistry, Pontifical Catholic University of Minas Gerais, Belo
Horizonte, Brazil.
Corresponding author: Dr Bernardo Quiroga Souki, Av Dom
Jose Gaspar, 500 Coracao Eucarstico, Belo Horizonte, Minas
Gerais CEP 30535-610, Brazil
(e-mail: bqsouki@gmail.com.br)
Accepted: March 2015. Submitted: January 2015.
Published Online: May 4, 2015
G 2016 by The EH Angle Education and Research Foundation,
Inc.
INTRODUCTION
Rapid maxillary expansion (RME) was introduced at
the end of 19th century,1 but only in the mid-1960s,
with the research of Haas,2 did it gain scientific
respect. Since then, several modifications in the
original expander design have been proposed.38
Substituting the original tissue-borne fixed splint acrylic
maxillary palate expander2 and toothborne all-metal
framework hygienic expanders (Hyrax)9 became very
popular among orthodontists.10 The safety of palatal
expansion has been consistently reported in the
orthodontic literature.1117 However, a high incidence
of external root resorption (ERR) is strongly associated
with abutment teeth after RME.1824
To improve the orthopedic effect, the original Haas
and Hyrax expanders have bands in the maxillary first
premolars and first molars.2,9 However, to simplify the
technique, a wire-supported anchorage replaced the
bands in the first premolars in several expander
models.4,6,25 Banded teeth receive a different load
compared with wire-supported teeth, and such a differ-
ence may have mechanical and biological effects that

DOI: 10.2319/011015-20.1 39 Angle Orthodontist, Vol 86, No 1, 2016

40
Figure 1. Flow chart of the sample distribution.
have not yet been fully examined. The decision about
whether the first premolars needs to be banded as
a preparation for RME should be based on scientific
evidence not only on practice management.
Thus, the aim of the present study was to assess
ERR when bands or wires are used as orthodontic
anchorage during RME. The null hypothesis was that
banded and nonbanded abutment first premolars
develop the same pattern of ERR after RME.
MATERIALS AND METHODS
Sample
The Institutional Review Board (IRB) of the Pontifical
Catholic University of Minas Gerais (Belo Horizonte,
Brazil) approved the current study. The rights of the
patients were protected, and their parents/guardians
signed the IRB-approved informed consent.
The sample consisted of 18 maxillary first premolars
and six mandibular first premolars from nine orthodontic
patients seen at the orthodontic clinic of the Pontifical
Catholic University of Minas Gerais, (four boys and five
girls). The patients had a mean age of 15.2 6 1.4 years
(range 5 1216 years old). All patients presented with
maxillary constriction, maxillary dental crowding, and/or
maxillary biprotrusion with orthodontic indication for
both RME and extraction of first premolars. None of the
patients had systemic problems, history of periodontal
disease, previous orthodontic treatment, and history of
carious lesions in the first premolars. First premolars
were in Nolla stages 9 and 10 of dental development.26
Angle Orthodontist, Vol 86, No 1, 2016
MARTINS, SOUKI, CHEIB, SILVA, REIS, OLIVEIRA, NUNES
From each extracted premolar, buccal, palatal, and
interproximal radicular surfaces were histologically
analyzed in two segments (cervical third and middle
third). The cervical third was the segment between the
cementoenamel junction and 4 mm apically; the middle
third extended 4 mm to 8 mm apically from the
cementoenamel junction. Thus, 108 sites were ana-
lyzed from the maxillary premolars and 36 sites from
the mandibular premolars (Figure 1).
Orthodontic Anchorage During RME
A modified 9-mm Hyrax expander (Morelli Ortodon-
tia, Sorocaba, Brazil) was used in the present study
(Figure 2). Orthodontic bands (American Orthodontics,
Sheboygan, Wis) were attached to both permanent
maxillary first molars and to only one maxillary first
premolar, which was randomly selected based on
a split-mouth design. The contralateral maxillary first
premolar was anchored on the palatine surface with an
orthodontic wire. The banded maxillary first premolars
(n 5 9) composed the band group (BG), and the
maxillary first premolars whose expansion load was
applied by the wire framework (n 5 9) made up the
wire group (WG). The screw was activated four turns
(0.8 mm) on the installation day, followed by one turn
twice a day (morning and night) during the next 14
days. Thus, the expansion screw was activated to 6.4
mm. All patients underwent 3 months of retention, and
the maxillary first premolars were then extracted by the
same oral surgeon. Contact of the forceps with root
ROOT RESORPTION AND MAXILLARY EXPANSION
Figure 2. Expander model used in the split-mouth design investiga-
tion. One first premolar was banded, while the contralateral received
the expansion load with a wire framework.
cementum was avoided. Six mandibular first premolars
served as the control group (CG). They were extracted
at the beginning of treatment, before any orthodontic
movement had been performed.
Histologic Preparation
After extraction and tap-water washing, a straight
longitudinal shallow groove was prepared as an
identification mark on the roots palatal surface with
a double-faced diamond disk under water-cooling
(Figure 3). To improve access of the fixing solution
into the root canal, 2 mm of the apical third was
removed immediately after extraction. The teeth
were stored and fixed in 10% neutral buffered formalin
for 72 hours. All samples processed for histology were
then rinsed with phosphate buffered saline wash buffer
(pH 7.3), immersed in Plancks solution for 36 hours,
and subsequently immersed in 4.13% EDTA (ethyle-
nediaminetetraacetic acid) decalcifying solution (Lenza
Farmaceutica, Belo Horizonte, Brazil) for 4 weeks, with
frequent changes. Following decalcification, the sam-
ples were processed for routine histology by paraffin
embedding. Sagittal sections (6 mm) were cut and
stained with hematoxylin and eosin for routine histol-
ogy. Samples from the radicular cervical and middle
thirds were prepared, taking into consideration the
distance from the cementoenamel junction (cervical,
04 mm; middle, 48 mm).
In each sample, the section with the largest root
resorption was selected for measurement. The sec-
tions were inspected using light microscopy and were
imaged at 103 magnification (Leica EZ4, Wetzlar,
41
Figure 3. Straight longitudinal shallow groove prepared on the roots
palatal surface.
Germany). For morphometric assessment, the apical
third was not considered.
Histologic evaluations were performed using ImageJ
software (National Institutes of Health, Bethesda, MD).
The following measurements were taken: (1) resorption
width (Figure 4a); (2) resorption depth (Figure 4a); (3)
lesion total area (Figure 4b); and (4) repair area
(Figure 4c).
Statistical Analysis
The same investigator performed blind measure-
ments. Descriptive statistics included means, standard
deviations, and medians. A x2 test was used in the
qualitative assessment of the association between the
ERR and (1) type of anchorage (BG and WG), (2) root
height position (middle and cervical thirds), and (3) root
surface (buccal, palatine, and interproximal). For
quantitative analysis, a t-test and analysis of variance
were used after confirmation of normality and homo-
scedasticity using Kolmogorov-Smirnov and Levene,
respectively. The SPSS 16.0 software (SPSS Inc,
Chicago, Ill) was used in the analysis at a significance
level of 5%.
RESULTS
ERR at the Level of Cementum and Dentin as well
as Cementum Repair Were Found in All Maxillary
First Premolars Subjected to RME
Three months after RME, all maxillary first premolars
showed cementum and dentin resorption (Figure 5) as
well as repair with cementum cells (Figures 6b through
6d). However, of the 108 examined maxillary pre-
molars samples, only one showed complete cementum
repair (Figure 6c). In all cases, the contour of the
resorption area could be easily identified in the
Angle Orthodontist, Vol 86, No 1, 2016
42 MARTINS, SOUKI, CHEIB, SILVA, REIS, OLIVEIRA, NUNES

Figure 4. (a) Continuous line indicates the width of resorption area; dashed line indicates the depth of resorption into the dentin. (b) Outline of the
lesion total area. (c) repair area. Bar 5 150 micrometer.

histologic evaluation (Figure 5). The mean resorption

depth was 177.59 mm, and the mean width was 856.59
mm. The mean area of repair in the total area of
resorption was 37%. Histologic examination of the six
untreated control mandibular premolars showed no root
resorption (Figure 6a).

ERR Was Similar When Orthodontic Bands or

Orthodontic Wire Were Used as Anchorage
During RME
Qualitative analysis showed that the type of anchor-
age for the first premolar (orthodontic band or wire) did
not affect the incidence of ERR (P . .05) (Table 1).
Quantitative analysis demonstrated that the lesion total Figure 6. (a) Arrow indicates the normal cementum in the first
premolar of the mandibular control. (b) Areas of repair with cellular
area, repair area, and depth of resorption were not
cementum (cc). (c) Solid black line shows the radicular topography
associated with the type of anchorage (Table 2). almost completed repaired with cellular cementum after the external
root resorption associated with rapid maxillary expansion. (d) Black
Radicular Cervical and Middle Thirds Had the arrows indicate the resorption outline. Bar 5 150 mm.
Same Pattern of ERR After RME
and the extension of ERR (lesion total area, repair
Tables 1 and 3 show that ERR in the middle and area, width, and depth of resorption) (P . .05).
cervical thirds was similar. In the cervical third, 18 of
the 54 analyzed samples showed ERR, and 19 of the Radicular Buccal Surface Had a Higher Amount of
54 samples of middle third showed ERR. In addition, ERR After RME
quantitative analysis (Table 3) showed that there was
no association between the radicular height position The buccal surfaces showed a greater incidence of
ERR compared with the palatine and interproximal
surfaces after RME (Table 1). The buccal surface also

Table 1. Association Between ERR and Anchorage Type, Tooth

Surface, and Analyzed Site (Cervical or Middle Third of the Root)a
ERR
Variables Yes No P Value
Anchorage type .068 NS
Band group 23 31
Wire group 14 40
Toth surface .002**
Buccal 19 17
Palatal 5 31
Interproximal 13 23
Analyzed site .839 NS
Middle third 19 35
Cervical third 18 36
a
Figure 5. External root resorption associated with rapid maxillary ERR indicates external root resorption; NS, not significant.
expansion in a banded first premolar. ** P , .01.

Angle Orthodontist, Vol 86, No 1, 2016

ROOT RESORPTION AND MAXILLARY EXPANSION 43

Table 2. Association Between Anchorage Type (BG vs WG) and ERR Measurementsa
BG WG t-Test
ERR Measurement Mean SD Mean SD P Value
2
Lesion total area (mm ) 34,823.8 69,659.6 27,842.6 65,530.7 .593 NS
Resorption depth (mm) 66.4 93.2 42.1 86.4 .164 NS
Resorption width (mm) 265.9 529.5 162.2 329.9 .232 NS
Repair area (mm2) 16,008.3 41,679.3 7129.5 17,080.8 .065 NS
a
BG indicates band group; WG, wire group; ERR, external root resorption; SD, standard deviation; NS, not significant.

showed more severe resorptive extension and had
a greater width and depth of resorption compared with
the palatine surface. Greater repair area was also
found in the buccal surface. However, no statistically
significant difference was found between the buccal
and interproximal surfaces (Table 4).
DISCUSSION
In the current investigation, all maxillary premolars
subjected to RME showed ERR reaching the cemen-
tum and dentin. Our finding was consistent with those
of previous reports, corroborating with evidence that
the RME is an orthodontic technique with a high rate of
root resorption of abutment teeth.2024,27,28 Because
both orthodontic bands and wires have been used as
anchorage devices in the first premolars, and wire
framework are routinely used to increase the anchor-
age in other maxillary posterior teeth, we aimed to
evaluate if there are differences in the pattern of ERR if
orthopedic heavy loads are applied in banded and
nonbanded teeth. We wished to find out which of these
two mechanisms was less biologically harmful to the
roots. Most of the previous investigations on this topic
found ERR in banded teeth,20,22,23,29 but a recent article
suggested that even nonbanded maxillary teeth are
also exposed to the risk of ERR after RME.24 We found
that both systems (band and wire) were associated
with ERR. However, no statistically significant differ-
ence was found between band and wire with regard to
the pattern of ERR.
Maintenance of the radicular resorptive process was
observed even when the expansion was terminated.
Our histologic evaluations performed 3 months after
the end of RME showed active signs of ERR. Such
a finding is in accordance with previous data. Accord-
ing to Barber and Sims20 and Langford,28 long-term
ERR is due to the accumulated loads in the appliance,
even after the activation period. Nevertheless, Zimring
and Isaacson17 have reported that the expander loads
are completed after 5 to 7 weeks.
With regard to the most resorbed root surface after
RME, previous studies have reported that the buccal
surface is the most affected in extension, depth, and
length,20,2224,27 while the palatine surface is the least
affected.20,21 Our findings were consistent with these
results. The greater compression loads transferred
onto the buccal surface during RME may account for
the greater ERR on the buccal surface. However, we
also found that the buccal surface showed greater
repair. Thus, we can infer that the resorbed sites are
likely to be repaired in the short term.
Clinicians routinely make a radiographic diagnosis of
ERR. However, radiographs cannot detect the micro-
scopic changes on the root surfaces compared with
a histologic examination.2931 Thus, radiography should
be used with caution in scientific investigations on ERR.
In the present study, a histologic evaluation of the
topographic changes on radicular surfaces was per-
formed to provide precise and reliable information
regarding the differences between the two types of
orthodontic anchorage. The sample size was adequate
for histologic analysis.
In our investigation, the mandibular first premolar
controls showed no signs of ERR. Such a finding was
consistent with those of previous studies.20,21 However,
Chan et al.32 found root resorption in nonorthodonti-
cally treated control teeth. These contrasting results
might be due to differences in the method of
measurement because they were performed using
scanning electronic microscopy analysis. We used an
expander model that was very similar to the one
proposed by Barber and Simms,20 but their expander

Table 3. Association Between Tooth Root Third (Middle vs Cervical Thirds) and ERR Measurementsa
Middle Third Cervical Third t-Test
ERR Measurement Mean SD Mean SD P Value
Lesion total area (mm2) 26,282.1 55,064.5 36,384.3 78,022.3 .439 NS
Resorption depth (mm) 51.7 84.2 56.8 96.7 .769 NS
Resorption width (mm) 223.7 480.3 205.3 405.9 .833 NS
Repair area (mm2) 13,247.4 29,982.1 9890.3 34,123.5 .588 NS
a
ERR indicates external root resorption; SD, standard deviation; NS, not significant.

Angle Orthodontist, Vol 86, No 1, 2016

44 MARTINS, SOUKI, CHEIB, SILVA, REIS, OLIVEIRA, NUNES

Table 4. Association Between Tooth Surface (Buccal vs Palatal vs Interproximal) and ERR Measurementa
Buccal Palatal Interproximal ANOVA
ERR Measurement Mean SD Mean SD Mean SD P Value
2
Lesion total area (mm ) 54,654.1 88,860.2 6121.1 20,580.5 33,224.5 65,968.0 .006b**
NSc,f
Resorption depth (mm) 78.8 97.9 19.4 54.9 64.6 101.7 .015b*
NSc,d
Resorption width (mm) 390.2 635.7 71.8 218.1 196.3 340.3 .008b**
NSc,d
Repair area (mm2) 23,311.6 46,455.5 1745.7 7006.8 9649.3 26,097.8 .012b*
NSc,d
a
ERR indicates external root resorption; ANOVA, analysis of variance with Bonferroni post hoc test; SD, standard deviation; NS, not
significant.
b
Buccal vs palatal.
c
Buccal vs interproximal.
d
Palatal vs interproximal.

had only one banded first premolar. The maxillary
contralateral tooth served as an unloaded control.
They reported no signs of ERR in control teeth.
The duration of the retention period is relatively
controversial in the orthodontic field. Periods ranging
from 3 to 12 months have been recommended.2,17
Apparently, the longer the retention time, the greater
the stability. According to Thorne et al.,33 a minimum of
3 months should be expected. We selected a 3-month
retention period because we aimed to evaluate the
histologic changes in the short term. Langford and
Sims22 found no relationship between the length of
retention and ERR in their study. However, Barber and
Sims20 reported that the ERR was more significant
between the end of the expansion and after 3 months
of retention. Vardimon et al.34 observed that the
cementum was rapidly laid down during the retention
period, but the increase in the formation of Sharpeys
fibers occurred during the postretention period, there-
by restricting the length of this phase. Nevertheless, it
is fair to infer that these heterogeneous findings may
be obtained with different retention periods. Thus, we
suggest that a similar research design should be used
with longer periods of retention. We propose that
additional areas of repair will be formed and that the
depth and width of the resorptive areas will be smaller.
The implications of ERR in terms of the longevity of
the teeth is uncertain.20 Orban35 reported that ortho-
dontically induced root resorption is transient and
results in no definitive damage, or it may only exhibit
a small radicular defect that does not affect the health
and physiologic function of the teeth in the long term.
However, there is little scientific evidence to support
this statement. In the current study, we found
consistent evidence that cells of the cementum lay
down in areas of resorption after the end of the active
treatment of RME. However, complete repair of the
resorption area by cementum cells was only observed
in one of the 108 samples, 3 months after the end of
RME. Moreover, this full radicular cementum repair
was not necessarily synonymous with the re-ligation of
the main periodontal fibers in the restored area.20
Thus, the present findings indicate that clinicians
need to consider the risks of RME. Unfortunately,
a dentist cannot precisely estimate the extension of root
resorption caused by RME in the short term. Further-
more, we have demonstrated for the first time that the
use of an orthodontic band as an anchorage does not
cause significantly more ERR compared with an
orthodontic wire.
CONCLUSIONS
N ERR at the level of the dentin and cementum and
partial cementum repair were found in all first
premolars 3 months after RME.
N The type of anchorage (orthodontic band or wire)
had no effect on ERR.
ACKNOWLEDGMENTS
We thank Dr Thiago Rego Motta and Dr Gabriela Godoy for
their great contribution during the experimental phase of this
research project, including the orthodontic treatment of the
patients.
REFERENCES
1. Angell EC. Treatment of irregularity of the permanent or
adult teeth. Dent Cosmet. 1860;1:540544.
2. Haas AJ. Rapid expansion of the maxillary dental arch and
nasal cavity by opening the midpalatal suture. Angle Orthod.
1961;31:7390.
3. Cozza P, Giancotti A, Petrosino A. Rapid palatal expansion
in mixed dentition using a modified expander: a cephalomet-
ric investigation. J Orthod. 2001;28:129134.
4. Domokos G, Denes J. Description of the Hyrax expansion
screw. Fogorv Sz. 1980;73:8081.
5. Figueiredo DSF, Bartolomeo FUC, Romualdo CR, et al.
Dentoskeletal effects of 3 maxillary expanders in patients
with clefts:a cone-beam computed tomography study.
Am J Orthod Dentofacial Orthop. 2014;146:7381.

Angle Orthodontist, Vol 86, No 1, 2016

ROOT RESORPTION AND MAXILLARY EXPANSION
6. Hamula W, Hamula DW, Hurt A. The hygienic rapid palatal
expander. J Clin Orthod. 1998;32:562567.
7. Lin L, Ahn H-W, Kim S-J, Moon S-C, Kim S-H, Nelson G.
Tooth-borne vs bone-borne rapid maxillary expanders in late
adolescence. Angle Orthod., 2015;85:253262.
8. Mahadevia S, Daruwala N, Vaghamshi M. eRMErapid
maxillary expansion in the economic way. Indian J Dent Res.
2011;22:734.
9. Asanza S, Cisneros GJ, Nieberg LG. Comparison of Hyrax
and bonded expansion appliances. Angle Orthod.
1997;67:1522.
10. Schuster G, Borel-Scherf I, Schopf PM. Frequency of and
complications in the use of RPE appliancesresults of
a survey in the Federal State of Hesse, Germany. J Orofac
Orthop. 2005;66:148161.
11. Haas AJ. Palatal expansion:just the beginning of dentofacial
orthopedics. Am J Orthod. 1970;57:219255.
12. Da Silva Filho OG, Boas MC, Capelozza Filho L. Rapid
maxillary expansion in the primary and mixed dentitions:
a cephalometric evaluation. Am J Orthod Dentofacial
Orthop. 1991;100:171179.
13. Weissheimer A, de Menezes LM, Mezomo M, Dias DM, de
Lima EMS, Rizzatto SMD. Immediate effects of rapid
maxillary expansion with Haas-type and hyrax-type expan-
ders:a randomized clinical trial. Am J Orthod Dentofacial
Orthop. 2011;140:366376.
14. Wertz RA. Skeletal and dental changes accompanying rapid
midpalatal suture opening. Am J Orthod. 1970;58:4166.
15. Ballanti F, Lione R, Baccetti T, Franchi L, Cozza P.
Treatment and posttreatment skeletal effects of rapid
maxillary expansion investigated with low-dose computed
tomography in growing subjects. Am J Orthod Dentofacial
Orthop. 2010;138:311317.
16. Lineberger MW, McNamara JA Jr, Baccetti T, Herberger T,
Franchi L. Effects of rapid maxillary expansion in hyperdi-
vergent patients. Am J Orthod Dentofacial Orthop. 2012;142:
6069.
17. Zimring JF, Isaacson RJ. Forces produced by rapid
maxillary expansion. Angle Orthod. 1965; 35:178186.
18. Rinderer L. The effects of expansion of the palatal suture.
Rep Congr Eur Orthod Soc. 1966;42:365382.
19. Timms DJ, Moss JP. An histological investigation into the
effects of rapid maxillary expansion on the teeth and their
supporting tissues. Trans Eur Orthod Soc. 1971:263271.
20. Barber AF, Sims MR. Rapid maxillary expansion and
external root resorption in man:a scanning electron micro-
scope study. Am J Orthod. 1981;79:630652.
45
21. Odenrick L, Lilja E, Lindback KF. Root surface resorption in
two cases of rapid maxillary expansion. Br J Orthod.
1982;9:3740.
22. Langford SR, Sims MR. Root surface resorption, repair, and
periodontal attachment following rapid maxillary expansion
in man. Am J Orthod. 1982;81:108115.
23. Erverdi N, Okar I, Kucukkeles N, Arbak S. A comparison of
two different rapid palatal expansion techniques from the
point of root resorption. Am J Orthod Dentofacial Orthop.
1994;106:4751.
24. Baysal A, Karadede I, Hekimoglu S, et al. Evaluation of root
resorption following rapid maxillary expansion using cone-beam
computed tomography. Angle Orthod. 2012;82:488494.
25. da Silva Filho OG, Boas MC, Capelozza Filho L. Rapid
maxillary expansion in the primary and mixed dentitions:
a cephalometric evaluation. Am J Orthod Dentofacial
Orthop. 1991;100:171179.
26. Nolla CM. The development of the human dentition.
ASDC J Dent Child. 1960;27:254266.
27. Odenrick L, Karlander EL, Pierce A, Kretschmar U. Surface
resorption following two forms of rapid maxillary expansion.
Eur J Orthod. 1991;13:264270.
28. Langford SR. Root resorption extremes resulting from
clinical RME. Am J Orthod. 1982;81:371377.
29. Acar A, Canyurek U, Kocaaga M, Erverdi N. Continuous vs.
discontinuous force application and root resorption. Angle
Orthod. 1999;69:159163.
30. Ohmae M, Saito S, Morohashi T, et al. A clinical and
histological evaluation of titanium mini-implants as anchors
for orthodontic intrusion in the beagle dog. Am J Orthod
Dentofacial Orthop. 2001;119:489497.
31. Owman-Moll P, Kurol J, Lundgren D. Continuous versus
interrupted continuous orthodontic force related to early
tooth movement and root resorption. Angle Orthod.
1995;65:395401.
32. Chan EKM, Darendeliler MA, Petocz P, Jones AS. A new
method for volumetric measurement of orthodontically
induced root resorption craters. Eur J Oral Sci.
2004;112:134139.
33. Thorne NAH. Experiences on widening the median maxillary
suture. Trans Eur Orthod Soc. 1956;32:279290.
34. Vardimon AD, Graber TM, Pitaru S. Repair process of external
root resorption subsequent to palatal expansion treatment.
Am J Orthod Dentofacial Orthop. 1993;103:120130.
35. Orban B. Resorption and repair on the surface of the root. J
Am Dent Assoc. 1928;15:17681777.
Angle Orthodontist, Vol 86, No 1, 2016