The role of cementoblasts in root resorption induced by orthodontic treatment: from mechanosensation to repair potential.

While alveolar bone has high remodeling activity under physiological conditions, cementum has a strong antiresorptive capacity. Cementoblasts are the primary functional and mechanosensitive cells on the cementum surface that maintain the structural homeostasis of the tooth root. However, excessive or sustained orthodontic force applied during treatment often induces irreversible orthodontically induced inflammatory root resorption (OIIRR), characterized by impaired cementoblast function and defective root surface repair. Although the precise molecular mechanisms underlying cementoblast dysfunction and the progression of root resorption under orthodontic force remain incompletely understood, posing major challenges for the prevention and management of OIIRR, orthodontic force-induced programmed cell death and secretory dysregulation in cementoblasts are known to hinder the self-repair of resorption lacunae, thereby exacerbating root tissue destruction. Consequently, intervention strategies-including physical therapy, pharmacological therapy, and biomaterial-based approaches-targeting the biological properties of cementoblasts are being developed to reactivate their differentiation and mineralization potential and promote functional repair of the root surface. This review provides a comprehensive overview of the biological role of cementoblasts in orthodontic root resorption and repair, establishing a theoretical basis and providing new insights for the development of cementoblast-targeted strategies to prevent and treat OIIRR.