Root surface microcracks induced by orthodontic force as a potential primary indicator of root resorption

Root resorption is closely related to orthodontic force and affects orthodontic treatment with high incidence; however, the mechanism governing this effect is unclear. Microcracks are associated with bone resorption and may also play an important role in root resorption. This study aimed to assess the occurrence of microcracks on the root surface induced by orthodontic force, analyze the association between force and microcrack development, and propose potential measures to reduce microcracks. Different loads (0.5, 1, or 2 N) were applied between the left first molar and anterior teeth for different durations (1, 3, 7, or 14 days) in a rabbit model. The first molar was dissected and its surface was examined using scanning electron microscopy (SEM), which revealed the presence of microcracks on the compressed side of the root apices. The number, width, and length of microcracks were all positively correlated with the load magnitude and duration. The breaking strength of the root apex was tested by using a digital force tester. In addition, a finite element (FE) model was used to analyze the stress at the root apices and the crack propagation on the root surfaces. FE analysis calculated that the regions of maximum stress at the root apices were consistent with the microcrack regions observed via SEM. These results imply that orthodontic force can directly induce the occurrence and development of microcrack, and may contribute to further root resorption. Therefore, an appropriate interval and direction of orthodontic force may help reduce microcracks and prevent root resorption.