Cellular and Molecular Pathways Leading to External Root Resorption

A. Iglesias-Linares, J. K. Hartsfield

Research output: Contribution to journalReview articlepeer-review

107 Scopus citations


External apical root resorption during orthodontic treatment implicates specific molecular pathways that orchestrate nonphysiologic cellular activation. To date, a substantial number of in vitro and in vivo molecular, genomic, and proteomic studies have supplied data that provide new insights into root resorption. Recent mechanisms and developments reviewed here include the role of the cellular component - specifically, the balance of CD68+, iNOS+M1- and CD68+, CD163+M2-like macrophages associated with root resorption and root surface repair processes linked to the expression of the M1-associated proinflammatory cytokine tumor necrosis factor, inducible nitric oxide synthase, the M1 activator interferon 3, the M2 activator interleukin 4, and M2-associated anti-inflammatory interleukin 10 and arginase I. Insights into the role of mesenchymal dental pulp cells in attenuating dentin resorption in homeostasis are also reviewed. Data on recently deciphered molecular pathways are reviewed at the level of (1) clastic cell adhesion in the external apical root resorption process and the specific role of α/β integrins, osteopontin, and related extracellular matrix proteins; (2) clastic cell fusion and activation by the RANKL/RANK/OPG and ATP-P2RX7-IL1 pathways; and (3) regulatory mechanisms of root resorption repair by cementum at the proteomic and transcriptomic levels.

Original languageEnglish
Pages (from-to)145-152
Number of pages8
JournalJournal of Dental Research
Issue number2
StatePublished - Feb 2017

Bibliographical note

Funding Information:
This study (PI-0609-2013) was supported by the Consejeria de Igualdad, Salud y Politicas Sociales. Junta de Andalucia. National Institutes of Health (P30GM110788 COBRE III; J.K.H.) and the University of Kentucky E. Preston Hicks Endowed Professorship (J.K.H.).

Publisher Copyright:
© International & American Associations for Dental Research 2016.


  • dental cementum
  • dentin
  • molecular mechanisms
  • orthodontics
  • root caries/resorption
  • tooth movement

ASJC Scopus subject areas

  • Dentistry (all)


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