Letters From Our Readers
To: Editor, The Angle Orthodontist
Re: Response to: Does pulp have a role in root resorption? Naphtali Brezniak; Atalia Wasserstein. The Angle Orthodontist. 2022; 92: 815–817.
We appreciate Dr Robert Kelleher's interest in our hypothesis: “Does pulp have a role in root resorption?” Researching any field in the profession is always necessary: in this case, dehiscences and fenestrations resulting from orthodontic treatment and their medico-legal connotations. Unfortunately, we do not share Dr Kelleher's thoughts or the following statement: “Understanding the etiology for apical root resorption may never emerge.” We believe that there is no biological event without a cause. We assumed that through the last 100 years, the pulp, as an organ involved in the devastating outcome of resorption, hasn't received the proper place in the process. Therefore, we studied it and hypothesized that as the reaction on the root surface is the outcome of a periodontal ligament's (PDL) defense mechanism (DM) activation to a local decrease in its blood flow, there might be another DM inside the tooth in the pulp that is being activated by precisely the same cause, a local decrease in the pulp's blood flow. This 'inside the pulp DM' activates a self-destructive mechanism. Its outcome is the devastating loss of the inside apical root material, while the crown's more critical and essential morphology and function are maintained.
We have to put effort into unveiling this long-lasting resorption myth to fulfill the desire of both Dr Kelleher and ourselves to better understand what and how to finish any treatment faster—and not only orthodontic treatment—with less damage.
With appreciation,
Naphtali Brezniak is the former head of the Orthodontic Residency, Israel Defense Forces, (retired from private practice), Tel-Aviv, Israel.
Atalia Wasserstein is Senior Clinical Lecturer, Orthodontic Department, Hebrew University, Jerusalem, and Clinical Instructor, Tel-Aviv University, Tel-Aviv, Israel. email: ataliawa@gmail.com