Orthodontically induced external apical root resorption considerations of root-filled teeth vs vital pulp teeth: a systematic review and meta-analysis

Abstract

Introduction The purpose of this systematic review was to research the difference between root-filled teeth (RFT) and vital pulp teeth (VPT) in orthodontically induced external apical root resorption (EARR) and to offer suggestions for clinicians on therapeutic sequence and timing when considering combined treatment of endodontic and orthodontic. Materials and methods An electronic search of published studies was conducted before November 2022 in PubMed, Web of Science and other databases. Eligibility criteria were based on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) framework. RevMan 5.3 software was used for statistical analysis. Single-factor meta-regression analysis was used to explore the sources of literature heterogeneity, and a random effects model was used for analysis. Results This meta-analysis comprised 8 studies with 10 sets of data. As there was significant heterogeneity among the studies, we employed a random effects model. The funnel plot of the random effects model exhibited a symmetrical distribution, indicating no publication bias among the included studies. The EARR rate of RFT was significantly lower than that of VPT. Conclusions In the context of concurrent endodontic and orthodontic treatment, priority should be given to endodontic therapy, as it serves as the foundation for subsequent orthodontic procedures. The optimal timing for orthodontic tooth movement post-root canal therapy is contingent upon factors such as the extent of periapical lesion resolution and the degree of dental trauma sustained. A comprehensive clinical assessment is essential in guiding the selection of the most suitable approach for achieving optimal treatment outcomes.

Hypoxic dental pulp stem cells-released succinate promotes osteoclastogenesis and root resorption

“…Therefore, metabolic signals from DPSCs might play a role in triggering OIIRR during OTM. Since most orthodontic force-induced root resorption is initiated from the apex and a reduced OIIRR is observed in endodontically treated teeth 18 , our present study demonstrated for the first time that hypoxic DPSCs generated succinate, which triggers osteoclastogenesis from mBMDMs and root resorption; therefore, the OIIRR may be a defense mechanism of pulp tissues to fulfill oxygen needs during OTM.…”

“…The role of dental pulp in OIIRR has been long recognized in the dental society, since nonvital teeth after root canal therapy showed reduced OIIRR when compared to its vital counterpart 18 , 19 ; however, the role of pulp tissues in the OIIRR has not been fully uncovered. OIIRR may be rather different from inflammatory root resorption in severely traumatized teeth.…”

Trabecular Bone Component Assessment under Orthodontic Loads and Movements during Periodontal Breakdown—A Finite Elements Analysis

“…Despite the mechano-biology behavior not being entirely understood [ 43 , 44 , 45 , 46 , 47 ], for an intact periodontium, there are reports of a safe applied force interval of 0.5–1 N as well as a larger interval of 0.28–3.31 N [ 19 , 24 , 48 , 49 , 50 , 51 , 52 ]. It must be emphasized that the external root resorption can also be induced by a multitude of other associated factors [ 31 , 32 , 40 , 42 , 49 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ]. However, the subject in this study is the biomechanical behavior of orthodontic force in both an intact and reduced periodontium; thus, the discussion favors only orthodontic root resorption under ischemic conditions.…”

“…There are no identified orthodontic root resorption studies for the reduced periodontium except for our earlier one [ 2 , 41 ]. Root resorption could also be induced by other associated factors such as age, population, osteoporosis, congenital syndromes, earlier trauma, or even endodontic treatments [ 31 , 32 , 40 , 42 , 49 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ].…”