Ruben Begino

Abstract

Background: Root resorption (RR) is a multifactorial process influenced by biological, environmental, and mechanical factors. Regional differences in RR prevalence have been minimally documented. After relocating from the U.S. West Coast to the Midwest, the author observed an unexpectedly higher incidence of radiographic RR findings in Midwest patients.

Methods: A retrospective review was conducted by the author using anonymized clinical charts and radiographs from two private practices — one located on the U.S. West Coast and the other in the Midwest — encompassing over 25 years of cumulative patient data. Comparable imaging protocols (periapical and CBCT) were used when possible. Cases were categorized by etiology, tooth type, and age group, enabling comparison of RR prevalence across regions.

Results: Midwestern patients demonstrated notably higher rates of idiopathic and inflammatory RR, independent of orthodontic history. Anterior teeth (particularly maxillary incisors) and patients aged 40 years and older were most frequently affected. No significant differences were found in trauma-associated or orthodontic cases. These findings suggest regional and systemic influences beyond local mechanical factors. 

Discussion: One plausible modifier may be vitamin D deficiency, which has higher prevalence in northern latitudes and is known to impact bone and cementum metabolism. The observed regional disparity aligns with existing epidemiologic data showing lower vitamin D levels in the Midwest compared to coastal regions. Other possible factors include dietary variation and mineral content in local water supplies.

Conclusion: These findings highlight the potential for geographic and systemic contributors to root resorption, emphasizing the need for increased diagnostic vigilance in higher-risk populations. Further multi-center studies are warranted to validate these preliminary observations and clarify the role of vitamin D and related metabolic factors.