Prevalence and associated factors of pathologic root resorption in primary molars and canines: a retrospective cross-sectional study

Objectives: Pathologic root resorption in primary teeth affects dental health and future orthodontic needs. This study aimed to evaluate the prevalence and associated factors of pathologic root resorption in a pediatric population.
Method and materials: A retrospective cross-sectional analysis was performed using panoramic radiographs from 691 pediatric patients aged 4 to 11 years at a university hospital in Türkiye. Teeth were evaluated for internal (IRR) and external pathologic root resorption (ERR) by two calibrated observers, adhering to the 2023 European Society of Endodontics Position Statement. Tooth status was categorized as healthy, carious (with or without pulp involvement), filled, or endodontically treated, and dental crowding was also recorded. Statistical analyses included chi-square tests, multiple logistic regression, and post-hoc analyses, with significance set at P < .05.
Results: A total of 7,729 primary teeth (5,075 molars and 2,654 canines) were evaluated, with interobserver reliability of 82% and intraobserver reliability of 98.8%. The study cohort included 691 children (mean age 7.05 ± 1.45 years; 49.8% boys, 50.2% girls). Pathologic root resorption was observed in 21.2% of cases (n = 1,638), with ERR accounting for 81% and IRR for 19%. Among 2,654 healthy teeth, 3.76% exhibited pathologic resorption, with no significant association with dental crowding. Significant relationships were identified between pathologic root resorption and age (P = .000), tooth status (P = .049), and sex (P = .042).
Conclusion: Reducing high caries levels in Türkiye is critical to lowering pathologic root resorption and associated complications. Further studies should explore dental crowding and pathologic root resorption relationships in larger samples.