GENETIC SUSCEPTIBILITY TO EXTERNAL ROOT RESORPTION FOLLOWING ENDODONTIC, ORTHODONTIC AND ORAL SURGICAL INTERVENTIONS: A CASE-CONTROL STUDY

Abstract

Background: External root resorption (ERR) is a pathological process that can be triggered by endodontic, orthodontic, and oral surgical procedures. While mechanical and inflammatory factors are well-recognized contributors, the role of genetic predisposition remains underexplored.

Objective: This case-control study aimed to investigate genetic polymorphisms in interleukin-1 alpha (IL-1α), IL-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), vitamin D receptor (VDR), and matrix metalloproteinase-9 (MMP-9) genes as potential susceptibility factors for treatment-induced ERR.

Methods: A total of 120 patients (60 cases with ERR and 60 controls without ERR) who had undergone endodontic, orthodontic, or oral surgical procedures were enrolled. Genetic analysis was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific PCR. Periapical radiographs and CBCT scans were used to confirm and grade ERR. Statistical analysis included chi-square tests, logistic regression, and Hardy-Weinberg equilibrium assessments.

Results: The IL-1β (+3953 C>T) TT genotype (OR=3.8, 95% CI: 1.9-7.6, p<0.001) and the TNF-α (-308 G>A) GA genotype (OR=2.6, 95% CI: 1.3-5.1, p=0.007) were significantly associated with increased ERR susceptibility. The VDR (FokI) ff genotype conferred significant risk (OR=2.9, 95% CI: 1.4-6.1, p=0.004). MMP-9 (C-1562T) T allele was significantly overrepresented in cases (p=0.012). No significant association was observed for IL-1α polymorphisms.

Conclusion: Specific pro-inflammatory and extracellular matrix degradation gene polymorphisms are significantly associated with ERR susceptibility following dental interventions. Genetic screening may facilitate personalized risk stratification and treatment planning.