The method of Root Canal Treatment before Extraction Technique in an Orthodontic Extraction Case
Main Article Content
Abstract
Extraction to resolve malocclusion is common in orthodontics, and it may take several months or years to close the extraction gap. Leaving an extraction site unclosed leads to alveolar bone resorption, narrowing the bone width and making it difficult to close the gap later. The study pertains to orthodontic cases with a substantial arch-length discrepancy that require extractions; Class II Division 1 and 2 cases typically favor first bicuspid extractions. The root canal treatment of the indicated extraction bicuspids facilitates interproximal reduction of the mesial and distal area, which will provide spaces. This method will offer the option to reduce the Arch Length Discrepancy and to delay extraction timing at the initial alignment stage. Therefore, given time for the orthodontist to align the crowded area and correct the Curve of Spee. The treatment could begin with bracket placement before reaching a stage where it is ready to extract the space, which was provided without extraction at the beginning.
This study aims to determine the time needed to close an extraction site in typical cases involving the removal of the first bicuspid tooth. The goal is to determine whether delaying extraction can shorten the time to close the extraction gap, thereby reducing overall orthodontic treatment time.
The timing results can then be compared with previous research outcomes to identify any differences or advantages of delaying extraction using the Root Canal First Before Extraction method.
Keywords:
regional acceleration phenomena (RAP), bone density, delayed tooth extraction timing, root canal treatment (RCT), ), time to close the extraction site in orthodontics, arch length discrepancy (ALD), interproximal reduction (IPR),, tooth movement.
Article Details
How to Cite
ROMANEC, Cristian et al.
The method of Root Canal Treatment before Extraction Technique in an Orthodontic Extraction Case.
Medical Research Archives, [S.l.], v. 13, n. 12, dec. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7016>. Date accessed: 02 jan. 2026.
doi: https://doi.org/10.18103/mra.v13i12.7016.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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19. Kuruthukulam RM, Patil AS. The center of resistance of a tooth: a review of the literature. Biophys Rev. 2023 Jan 17;15(1):35-41. doi: 10.1007/s12551-023-01042-z. PMID: 36909954; PMCID: PMC9995625.
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21. Chang HW, Huang HL, Yu JH, Hsu JT, Li YF, Wu YF. Effects of orthodontic tooth movement on alveolar bone density. Clin Oral Investig. 2012 Jun;16(3):679-88. doi: 10.1007/s00784-011-0552-9. Epub 2011 Apr 26. PMID: 21519883.
22. Alhiraky S, Konermann A, Keilig L, Bourauel C. Numerical Simulation of Maxillary Anterior Teeth Retraction Utilizing Power Arms in Lingual Orthodontic Technique. J Pers Med. 2024 Sep 17;14(9):988. doi: 10.3390/jpm14090988. PMID: 39338242; PMCID: PMC11432823.
23. Liu D, Yan B, Lei F, Li J, Wang X, Rong Q, Zhou Y. Different sliding mechanics in space closure of lingual orthodontics: a translational study by three-dimensional finite element method. Am J Transl Res. 2019 Jan 15;11(1):120-130. PMID: 30787973; PMCID: PMC6357325.
24. Mattu N, Virupaksha AM, Belludi A. Comparative study of effect of different lever arm positions and lengths on transverse and vertical bowing in lingual orthodontics - An FEM study. Int Orthod. 2021 Jun;19(2):281-290. doi: 10.1016/j.ortho.2021.03.003. Epub 2021 Apr 9. Erratum in: Int Orthod. 2024 Jun;22(2):100850. doi: 10.1016/j.ortho.2024.100850. PMID: 33846065.
25. Park HS, Lee YJ, Jeong SH, Kwon TG. Density of the alveolar and basal bones of the maxilla and the mandible. Am J Orthod Dentofacial Orthop. 2008 Jan;133(1):30-7. doi: 10.1016/j.ajodo.2006.01.044. PMID: 18174068.
26. Ma ZG, Yang C, Fang B, et al. Three-D imaging of dental alveolar bone change after fixed orthodontic treatment in patients with periodontitis. Int J Clin Exp Med 2015; 8:2385–2391.
27. Huang H, Richards M, Bedair T, et al. Effects of orthodontic treatment on human alveolar bone density distribution. Clin Oral Investig 2013; 17:2033–2040.
28. Chang, Hsing-Wen & Huang, Heng Li & Yu, Jian-Hong & Hsu, Jui-Ting & Li, Yu-Fen & Wu, Yi-Fan. (2011). Effects of orthodontic tooth movement on alveolar bone density. Clinical oral investigations. 16. 679-88. 10.1007/s00784-011-0552-9.
29. Ritwiroon, Nawaporn & Suzuki, Boonsiva & Suzuki, Eduardo Yugo. (2021). Effects of Alveolar Bone Width and Density on the Rate of Orthodontic Tooth Movement Introduction Material and Methods. The Journal of the Dental Association of Thailand. 71. 53-63. 10.14456/jdat.2021.6.
30. Frost HM. The regional acceleratory phenomenon: a review. Henry Ford Hosp Med J. 1983;31(1):3–9. [PubMed] [Google Scholar]
31. Danz, J. C., & Degen, M. (2025). Selective modulation of the bone remodeling regulatory system through orthodontic tooth movement—A review. Frontiers in Oral Health, 6, 1472711. https://doi.org/10.3389/froh.2025.1472711
32. Gadhia A, Pepper T. Oral Surgery, Extraction of Teeth. [Updated 2023 Jun 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK589654/
33. Schneider PP, Kim KB, da Costa Monini A, Dos Santos-Pinto A, Gandini LG Júnior. Which one closes extraction spaces faster: en masse retraction or two-step retraction? A randomized prospective clinical trial. Angle Orthod. 2019 Nov;89(6):855-861. doi: 10.2319/101618-748.1. Epub 2019 Jul 1. PMID: 31259616; PMCID: PMC8109172.
34. Moresca R. Orthodontic treatment time: can it be shortened? Dental Press J Orthod. 2018 Nov-Dec;23(6):90-105. doi: 10.1590/2177-6709.23.6.090-105.sar. PMID: 30672990; PMCID: PMC6340199.
35. Jiang F, Liu SS, Xia Z, Li S, Chen J, Kula KS, Eckert G. Hounsfield unit change in root and alveolar bone during canine retraction. Am J Orthod Dentofacial Orthop. 2015 Apr;147(4):445-53. doi: 10.1016/j.ajodo.2014.11.027. PMID: 25836004; PMCID: PMC4385197.
2. Tan, W. L., T. Wong, T. L., M. Wong, M. C., & Lang, N. P. A systematic review of post-extraction alveolar hard and soft tissue dimensional changes in humans. Clinical Oral Implants Research, 23, 1-21. https://doi.org/10.1111/j.1600-0501.2011.02375.x
3. Jahangiri L, Devlin H, Ting K, Nishimura I. Current perspectives in residual ridge remodeling and its clinical implications: a review. J Prosthet Dent. 1998 Aug;80(2):224-37. doi: 10.1016/s0022-3913(98)70116-7. PMID: 9710828.
4. Barone A, Ricci M, Tonelli P, Santini S, Covani U. Tissue changes of extraction sockets in humans: a comparison of spontaneous healing vs. ridge preservation with secondary soft tissue healing. Clin Oral Implants Res. 2013 Nov;24(11):1231-7. doi: 10.1111/j.1600-0501.2012.02535.x. Epub 2012 Jul 12. PMID: 22784417.
5. John G. Edwards, The prevention of relapse in extraction cases, AJO, Volume 60, Issue 2, 1971, Pages 128-141, ISSN 0002-9416, https://doi.org/10.1016/0002-9416(71)90029
6. Priya D, Sundareswaran S, Mishra N, Sathyanathan S, Shibin M, Jisha B. Timing of Therapeutic Extractions Can Affect En Masse Anterior Retraction: A Split Mouth Randomized Clinical Trial. Turk J Orthod. 2024 Dec 31;37(4):213-220. doi: 10.4274/TurkJOrthod.2024.2023.6. PMID: 39743844; PMCID: PMC11705195.
7. Verna C. Regional Acceleratory Phenomenon. Front Oral Biol. 2016;18:28-35. doi: 10.1159/000351897. Epub 2015 Nov 24. PMID: 26599115.
8. Mathews DP, Kokich VG. Accelerating tooth movement: the case against corticotomy-induced orthodontics. Am J Orthod Dentofacial Orthop. 2013 Jul;144(1):5-13. doi: 10.1016/j.ajodo.2013.04.008. PMID: 23810039.
9. Park, H., Lee, Y., Jeong, S., & Kwon, T. (2007). Density of the alveolar and basal bones of the maxilla and the mandible. American Journal of Orthodontics and Dentofacial Orthopedics, 133(1), 30-37. https://doi.org/10.1016/j.ajodo.2006.01.044
10. Yu JH, Huang HL, Liu CF, Wu J, Li YF, Tsai MT, Hsu JT. Does Orthodontic Treatment Affect the Alveolar Bone Density? Medicine (Baltimore). 2016 Mar;95(10):e3080. doi: 10.1097/MD.000000000 0003080. PMID: 26962841; PMCID: PMC4998922.
11. Hsu JT, Chang HW, Huang HL, Yu JH, Li YF, Tu MG. Bone density changes around teeth during orthodontic treatment. Clin Oral Investig. 2011 Aug;15(4):511-9. doi: 10.1007/s00784-010-0410-1. PMID: 20393863.
12. Daraqel B, Mheissen S, Li J, Khan H, Allan S, Zheng L. The effect of early versus delayed space closure on the rate of orthodontic tooth movement: a systematic review and meta-analysis. Eur J Orthod. 2023 Nov 30;45(6):680-689. doi: 10.1093/ejo/cjad015. PMID: 37203234.
13. Abu Alhaija ES, Al Shayeb RA, Al-Khateeb S, Daher HO, Daher SO. A comparative assessment of the amount and rate of orthodontic space closure toward a healed vs recent lower premolar extraction site. Angle Orthod. 2022 Jul 1;92(4):463-470. doi: 10.2319/102921-797.1. PMID: 35344007; PMCID: PMC9235382.
14. Proffit, William R., Henry W. Fields, and David M. Sarver. Contemporary Orthodontics. St. Louis, MO: Elsevier/Mosby, 2013.
15. Mapare S, Mundada R, Karra A, Agrawal S, Mahajan SB, Tadawalkar A. Extraction or Nonextraction in Orthodontic Cases: A Review. J Pharm Bioallied Sci. 2021 Jun;13(Suppl 1):S2-S5. doi: 10.4103/jpbs.JPBS_549_20. Epub 2021 Jun 5. PMID: 34447032; PMCID: PMC8375952.
16. Edwards, J. G. (1971). The prevention of relapse in extraction cases. American Journal of Orthodontics, 60(2), 128-141. https://doi.org/10.1016/0002-9416(71)90029-7
17. Schreiber JJ, Anderson PA, Rosas HG, Buchholz AL, Au AG. Hounsfield units for assessing bone mineral density and strength: a tool for osteoporosis management. J Bone Joint Surg Am. 2011 Jun 1;93(11):1057-63. doi: 10.2106/JBJS.J.00160. PMID: 21655899.
18. Vitral RW, Fraga MR, da Silva Campos MJ. Use of Hounsfield units in cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2015 Aug;148(2):204. doi: 10.1016/j.ajodo.2015.05.005. PMID: 26232821.
19. Kuruthukulam RM, Patil AS. The center of resistance of a tooth: a review of the literature. Biophys Rev. 2023 Jan 17;15(1):35-41. doi: 10.1007/s12551-023-01042-z. PMID: 36909954; PMCID: PMC9995625.
20. Yoshida N, Jost-Brinkmann PG, Koga Y, Mimaki N, Kobayashi K. Experimental evaluation of initial tooth displacement, center of resistance, and center of rotation under the influence of an orthodontic force. Am J Orthod Dentofacial Orthop. 2001 Aug;120(2):190-7. doi: 10.1067/mod.2001.115036. PMID: 11500662.
21. Chang HW, Huang HL, Yu JH, Hsu JT, Li YF, Wu YF. Effects of orthodontic tooth movement on alveolar bone density. Clin Oral Investig. 2012 Jun;16(3):679-88. doi: 10.1007/s00784-011-0552-9. Epub 2011 Apr 26. PMID: 21519883.
22. Alhiraky S, Konermann A, Keilig L, Bourauel C. Numerical Simulation of Maxillary Anterior Teeth Retraction Utilizing Power Arms in Lingual Orthodontic Technique. J Pers Med. 2024 Sep 17;14(9):988. doi: 10.3390/jpm14090988. PMID: 39338242; PMCID: PMC11432823.
23. Liu D, Yan B, Lei F, Li J, Wang X, Rong Q, Zhou Y. Different sliding mechanics in space closure of lingual orthodontics: a translational study by three-dimensional finite element method. Am J Transl Res. 2019 Jan 15;11(1):120-130. PMID: 30787973; PMCID: PMC6357325.
24. Mattu N, Virupaksha AM, Belludi A. Comparative study of effect of different lever arm positions and lengths on transverse and vertical bowing in lingual orthodontics - An FEM study. Int Orthod. 2021 Jun;19(2):281-290. doi: 10.1016/j.ortho.2021.03.003. Epub 2021 Apr 9. Erratum in: Int Orthod. 2024 Jun;22(2):100850. doi: 10.1016/j.ortho.2024.100850. PMID: 33846065.
25. Park HS, Lee YJ, Jeong SH, Kwon TG. Density of the alveolar and basal bones of the maxilla and the mandible. Am J Orthod Dentofacial Orthop. 2008 Jan;133(1):30-7. doi: 10.1016/j.ajodo.2006.01.044. PMID: 18174068.
26. Ma ZG, Yang C, Fang B, et al. Three-D imaging of dental alveolar bone change after fixed orthodontic treatment in patients with periodontitis. Int J Clin Exp Med 2015; 8:2385–2391.
27. Huang H, Richards M, Bedair T, et al. Effects of orthodontic treatment on human alveolar bone density distribution. Clin Oral Investig 2013; 17:2033–2040.
28. Chang, Hsing-Wen & Huang, Heng Li & Yu, Jian-Hong & Hsu, Jui-Ting & Li, Yu-Fen & Wu, Yi-Fan. (2011). Effects of orthodontic tooth movement on alveolar bone density. Clinical oral investigations. 16. 679-88. 10.1007/s00784-011-0552-9.
29. Ritwiroon, Nawaporn & Suzuki, Boonsiva & Suzuki, Eduardo Yugo. (2021). Effects of Alveolar Bone Width and Density on the Rate of Orthodontic Tooth Movement Introduction Material and Methods. The Journal of the Dental Association of Thailand. 71. 53-63. 10.14456/jdat.2021.6.
30. Frost HM. The regional acceleratory phenomenon: a review. Henry Ford Hosp Med J. 1983;31(1):3–9. [PubMed] [Google Scholar]
31. Danz, J. C., & Degen, M. (2025). Selective modulation of the bone remodeling regulatory system through orthodontic tooth movement—A review. Frontiers in Oral Health, 6, 1472711. https://doi.org/10.3389/froh.2025.1472711
32. Gadhia A, Pepper T. Oral Surgery, Extraction of Teeth. [Updated 2023 Jun 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK589654/
33. Schneider PP, Kim KB, da Costa Monini A, Dos Santos-Pinto A, Gandini LG Júnior. Which one closes extraction spaces faster: en masse retraction or two-step retraction? A randomized prospective clinical trial. Angle Orthod. 2019 Nov;89(6):855-861. doi: 10.2319/101618-748.1. Epub 2019 Jul 1. PMID: 31259616; PMCID: PMC8109172.
34. Moresca R. Orthodontic treatment time: can it be shortened? Dental Press J Orthod. 2018 Nov-Dec;23(6):90-105. doi: 10.1590/2177-6709.23.6.090-105.sar. PMID: 30672990; PMCID: PMC6340199.
35. Jiang F, Liu SS, Xia Z, Li S, Chen J, Kula KS, Eckert G. Hounsfield unit change in root and alveolar bone during canine retraction. Am J Orthod Dentofacial Orthop. 2015 Apr;147(4):445-53. doi: 10.1016/j.ajodo.2014.11.027. PMID: 25836004; PMCID: PMC4385197.