Skip to main content
Top
Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Research

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

Authors: Danning Zhao, Kun Xue, Jiayuan Meng, Meijing Hu, Fei Bi, Xuelian Tan

Published in: BMC Oral Health | Issue 1/2023

Login to get access

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.
Literature
1.
go back to reference Feller L, Khammissa RA, Thomadakis G, Fourie J, Lemmer J. Apical External Root Resorption and Repair in Orthodontic Tooth Movement: Biological Events. Biomed Res Int. 2016;2016:4864195.CrossRefPubMedPubMedCentral Feller L, Khammissa RA, Thomadakis G, Fourie J, Lemmer J. Apical External Root Resorption and Repair in Orthodontic Tooth Movement: Biological Events. Biomed Res Int. 2016;2016:4864195.CrossRefPubMedPubMedCentral
3.
go back to reference Nayyer N, Tripathi T, Rai P, Kanase A. Effect of photobiomodulation on external root resorption during orthodontic tooth movement – a randomized controlled trial. Int Orthod. 2021;19(2):197–206.CrossRefPubMed Nayyer N, Tripathi T, Rai P, Kanase A. Effect of photobiomodulation on external root resorption during orthodontic tooth movement – a randomized controlled trial. Int Orthod. 2021;19(2):197–206.CrossRefPubMed
4.
go back to reference Bayir F, Bolat GE. External apical root resorption after orthodontic treatment: Incidence, severity and risk factors. J Dent Res Dent Clin Dent Prospects. 2021;15(2):100–5.CrossRefPubMedPubMedCentral Bayir F, Bolat GE. External apical root resorption after orthodontic treatment: Incidence, severity and risk factors. J Dent Res Dent Clin Dent Prospects. 2021;15(2):100–5.CrossRefPubMedPubMedCentral
5.
go back to reference Krishnan V. Root Resorption with Orthodontic Mechanics: Pertinent Areas Revisited. Aust Dent J. 2017;62(Suppl 1):71–7.CrossRefPubMed Krishnan V. Root Resorption with Orthodontic Mechanics: Pertinent Areas Revisited. Aust Dent J. 2017;62(Suppl 1):71–7.CrossRefPubMed
6.
go back to reference Aidos H, Diogo P, Santos JM. Root Resorption Classifications: A Narrative Review and a Clinical Aid Proposal for Routine Assessment. Eur Endod J. 2018;3(3):134–45.PubMedPubMedCentral Aidos H, Diogo P, Santos JM. Root Resorption Classifications: A Narrative Review and a Clinical Aid Proposal for Routine Assessment. Eur Endod J. 2018;3(3):134–45.PubMedPubMedCentral
7.
go back to reference Kamat M, Puranik R, Vanaki S, Kamat S. An insight into the regulatory mechanisms of cells involved in resorption of dental hard tissues. J Oral Maxillofac Pathol. 2013;17(2):228–33.CrossRefPubMedPubMedCentral Kamat M, Puranik R, Vanaki S, Kamat S. An insight into the regulatory mechanisms of cells involved in resorption of dental hard tissues. J Oral Maxillofac Pathol. 2013;17(2):228–33.CrossRefPubMedPubMedCentral
8.
go back to reference Sameshima GT, Iglesias-Linares A. Orthodontic root resorption. J World Fed Orthod. 2021;10(4):135–43.CrossRefPubMed Sameshima GT, Iglesias-Linares A. Orthodontic root resorption. J World Fed Orthod. 2021;10(4):135–43.CrossRefPubMed
9.
go back to reference Yassir YA, McIntyre GT, Bearn DR. Orthodontic treatment and root resorption: an overview of systematic reviews. Eur J Orthod. 2021;43(4):442–56.CrossRefPubMed Yassir YA, McIntyre GT, Bearn DR. Orthodontic treatment and root resorption: an overview of systematic reviews. Eur J Orthod. 2021;43(4):442–56.CrossRefPubMed
10.
go back to reference Samandara A, Papageorgiou SN, Ioannidou-Marathiotou I, Kavvadia-Tsatala S, Papadopoulos MA. Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis. Eur J Orthod. 2019;41(1):67–79.CrossRefPubMed Samandara A, Papageorgiou SN, Ioannidou-Marathiotou I, Kavvadia-Tsatala S, Papadopoulos MA. Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis. Eur J Orthod. 2019;41(1):67–79.CrossRefPubMed
11.
go back to reference Pustułka K, Trzcionka A, Dziedzic A, Skaba D, Tanasiewicz M. The Radiological Assessment of Root Features and Periodontal Structures in Endodontically Treated Teeth Subjected to Forces Generated by Fixed Orthodontic Appliances. A Prospective, Clinical Cohort Study. J Clin Med. 2021;10(10). https://doi.org/10.3390/jcm10102078. Pustułka K, Trzcionka A, Dziedzic A, Skaba D, Tanasiewicz M. The Radiological Assessment of Root Features and Periodontal Structures in Endodontically Treated Teeth Subjected to Forces Generated by Fixed Orthodontic Appliances. A Prospective, Clinical Cohort Study. J Clin Med. 2021;10(10). https://​doi.​org/​10.​3390/​jcm10102078.
12.
go back to reference Khan RA, Kumar S, Hassan N, Anand B, Mazhar S, Anjan R. Root Resorption of Endodontically Treated Teeth Following Orthodontic Treatment: A Cross-Sectional Study. J Pharm Bioallied Sci. 2021;13(Suppl 2):S1306–8.PubMedPubMedCentral Khan RA, Kumar S, Hassan N, Anand B, Mazhar S, Anjan R. Root Resorption of Endodontically Treated Teeth Following Orthodontic Treatment: A Cross-Sectional Study. J Pharm Bioallied Sci. 2021;13(Suppl 2):S1306–8.PubMedPubMedCentral
13.
go back to reference Lee YJ, Lee TY. External root resorption during orthodontic treatment in root-filled teeth and contralateral teeth with vital pulp: A clinical study of contributing factors. Am J Orthod Dentofacial Orthop. 2016;149(1):84–91.CrossRefPubMed Lee YJ, Lee TY. External root resorption during orthodontic treatment in root-filled teeth and contralateral teeth with vital pulp: A clinical study of contributing factors. Am J Orthod Dentofacial Orthop. 2016;149(1):84–91.CrossRefPubMed
14.
go back to reference Khan AR, Fida M, Shaikh A. Evaluation Of Apical Root Resorption In Endodontically Treated And Vital Teeth In Adult Orthodontic Subjects. J Ayub Med Coll Abbottabad. 2018;30(4):506–10.PubMed Khan AR, Fida M, Shaikh A. Evaluation Of Apical Root Resorption In Endodontically Treated And Vital Teeth In Adult Orthodontic Subjects. J Ayub Med Coll Abbottabad. 2018;30(4):506–10.PubMed
15.
go back to reference Kolcuoğlu K, Oz AZ. Comparison of orthodontic root resorption of root-filled and vital teeth using micro-computed tomography. Angle Orthod. 2020;90(1):56–62.CrossRefPubMed Kolcuoğlu K, Oz AZ. Comparison of orthodontic root resorption of root-filled and vital teeth using micro-computed tomography. Angle Orthod. 2020;90(1):56–62.CrossRefPubMed
16.
go back to reference Yoshpe M, Einy S, Ruparel N, Lin S, Kaufman AY. Regenerative Endodontics: A Potential Solution for External Root Resorption (Case Series). J Endod. 2020;46(2):192–9.CrossRefPubMed Yoshpe M, Einy S, Ruparel N, Lin S, Kaufman AY. Regenerative Endodontics: A Potential Solution for External Root Resorption (Case Series). J Endod. 2020;46(2):192–9.CrossRefPubMed
17.
go back to reference Llamas-Carreras JM, Amarilla A, Solano E, Velasco-Ortega E, Rodríguez-Varo L, Segura-Egea JJ. Study of external root resorption during orthodontic treatment in root filled teeth compared with their contralateral teeth with vital pulps. Int Endod J. 2010;43(8):654–62.CrossRefPubMed Llamas-Carreras JM, Amarilla A, Solano E, Velasco-Ortega E, Rodríguez-Varo L, Segura-Egea JJ. Study of external root resorption during orthodontic treatment in root filled teeth compared with their contralateral teeth with vital pulps. Int Endod J. 2010;43(8):654–62.CrossRefPubMed
18.
go back to reference Bellini-Pereira SA, Almeida J, Aliaga-Del Castillo A, Dos Santos CCO, Henriques JFC, Janson G. Evaluation of root resorption following orthodontic intrusion: a systematic review and meta-analysis. Eur J Orthod. 2021;43(4):432–41.CrossRefPubMed Bellini-Pereira SA, Almeida J, Aliaga-Del Castillo A, Dos Santos CCO, Henriques JFC, Janson G. Evaluation of root resorption following orthodontic intrusion: a systematic review and meta-analysis. Eur J Orthod. 2021;43(4):432–41.CrossRefPubMed
19.
go back to reference Alqerban A, Almanea A, Alkanhal A, Aljarbou F, Almassen M, Fieuws S, et al. Impact of orthodontic treatment on the integrity of endodontically treated teeth. Eur J Orthod. 2019;41(3):238–43.CrossRefPubMed Alqerban A, Almanea A, Alkanhal A, Aljarbou F, Almassen M, Fieuws S, et al. Impact of orthodontic treatment on the integrity of endodontically treated teeth. Eur J Orthod. 2019;41(3):238–43.CrossRefPubMed
20.
go back to reference Kalra S, Gupta P, Tripathi T, Rai P. External apical root resorption in orthodontic patients: molecular and genetic basis. J Family Med Prim Care. 2020;9(8):3872–82.CrossRefPubMedPubMedCentral Kalra S, Gupta P, Tripathi T, Rai P. External apical root resorption in orthodontic patients: molecular and genetic basis. J Family Med Prim Care. 2020;9(8):3872–82.CrossRefPubMedPubMedCentral
21.
go back to reference Ioannidou-Marathiotou I, Zafeiriadis AA, Papadopoulos MA. Root resorption of endodontically treated teeth following orthodontic treatment: a meta-analysis. Clin Oral Investig. 2013;17(7):1733–44.CrossRefPubMed Ioannidou-Marathiotou I, Zafeiriadis AA, Papadopoulos MA. Root resorption of endodontically treated teeth following orthodontic treatment: a meta-analysis. Clin Oral Investig. 2013;17(7):1733–44.CrossRefPubMed
22.
go back to reference Alhadainy HA, Flores-Mir C, Abdel-Karim AH, Crossman J, El-Bialy T. Orthodontic-induced External Root Resorption of Endodontically Treated Teeth: A Meta-analysis. J Endod. 2019;45(5):483–9.CrossRefPubMed Alhadainy HA, Flores-Mir C, Abdel-Karim AH, Crossman J, El-Bialy T. Orthodontic-induced External Root Resorption of Endodontically Treated Teeth: A Meta-analysis. J Endod. 2019;45(5):483–9.CrossRefPubMed
23.
go back to reference de Souza RS, de Souza V, Holland R, Gomes-Filho JE, Murata SS, Sonoda CK. Effect of calcium hydroxide-based materials on periapical tissue healing and orthodontic root resorption of endodontically treated teeth in dogs. Dent Traumatol. 2009;25(2):213–8.CrossRefPubMed de Souza RS, de Souza V, Holland R, Gomes-Filho JE, Murata SS, Sonoda CK. Effect of calcium hydroxide-based materials on periapical tissue healing and orthodontic root resorption of endodontically treated teeth in dogs. Dent Traumatol. 2009;25(2):213–8.CrossRefPubMed
24.
go back to reference Chaniotis A. Orthodontic Movement after Regenerative Endodontic Procedure: Case Report and Long-term Observations. J Endod. 2018;44(3):432–7.CrossRefPubMed Chaniotis A. Orthodontic Movement after Regenerative Endodontic Procedure: Case Report and Long-term Observations. J Endod. 2018;44(3):432–7.CrossRefPubMed
25.
go back to reference McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, et al. Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement. JAMA. 2018;319(4):388–96.CrossRefPubMed McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, et al. Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement. JAMA. 2018;319(4):388–96.CrossRefPubMed
26.
go back to reference Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.CrossRefPubMedPubMedCentral Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.CrossRefPubMedPubMedCentral
27.
go back to reference Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383–94.CrossRefPubMed Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383–94.CrossRefPubMed
28.
go back to reference Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401–6.CrossRefPubMed Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401–6.CrossRefPubMed
29.
go back to reference Spurrier SW, Hall SH, Joondeph DR, Shapiro PA, Riedel RA. A comparison of apical root resorption during orthodontic treatment in endodontically treated and vital teeth. Am J Orthod Dentofacial Orthop. 1990;97(2):130–4.CrossRefPubMed Spurrier SW, Hall SH, Joondeph DR, Shapiro PA, Riedel RA. A comparison of apical root resorption during orthodontic treatment in endodontically treated and vital teeth. Am J Orthod Dentofacial Orthop. 1990;97(2):130–4.CrossRefPubMed
30.
go back to reference Esteves T, Ramos AL, Pereira CM, Hidalgo MM. Orthodontic root resorption of endodontically treated teeth. J Endod. 2007;33(2):119–22.CrossRefPubMed Esteves T, Ramos AL, Pereira CM, Hidalgo MM. Orthodontic root resorption of endodontically treated teeth. J Endod. 2007;33(2):119–22.CrossRefPubMed
31.
go back to reference Castro I, Valladares-Neto J, Estrela C. Contribution of cone beam computed tomography to the detection of apical root resorption after orthodontic treatment in root-filled and vital teeth. Angle Orthod. 2015;85(5):771–6.CrossRefPubMed Castro I, Valladares-Neto J, Estrela C. Contribution of cone beam computed tomography to the detection of apical root resorption after orthodontic treatment in root-filled and vital teeth. Angle Orthod. 2015;85(5):771–6.CrossRefPubMed
32.
go back to reference Llamas-Carreras JM, Amarilla A, Espinar-Escalona E, Castellanos-Cosano L, Martín-González J, Sánchez-Domínguez B, et al. External apical root resorption in maxillary root-filled incisors after orthodontic treatment: a split-mouth design study. Med Oral Patol Oral Cir Bucal. 2012;17(3):e523–7.CrossRefPubMed Llamas-Carreras JM, Amarilla A, Espinar-Escalona E, Castellanos-Cosano L, Martín-González J, Sánchez-Domínguez B, et al. External apical root resorption in maxillary root-filled incisors after orthodontic treatment: a split-mouth design study. Med Oral Patol Oral Cir Bucal. 2012;17(3):e523–7.CrossRefPubMed
33.
go back to reference Yanli W, Yuguang G. The study of orthodontic treatment on root resorption of nonvital pulp teeth and vital pulp teeth. BMU J. 2017;40(2):123–5. Yanli W, Yuguang G. The study of orthodontic treatment on root resorption of nonvital pulp teeth and vital pulp teeth. BMU J. 2017;40(2):123–5.
34.
go back to reference Li Y, Jacox LA, Little SH, Ko CC. Orthodontic tooth movement: The biology and clinical implications. Kaohsiung J Med Sci. 2018;34(4):207–14.CrossRefPubMed Li Y, Jacox LA, Little SH, Ko CC. Orthodontic tooth movement: The biology and clinical implications. Kaohsiung J Med Sci. 2018;34(4):207–14.CrossRefPubMed
35.
go back to reference Yamamoto T, Kaku M, Sumi H, Yashima Y, Izumino J, Tanimoto K. Effects of loxoprofen on the apical root resorption during orthodontic tooth movement in rats. PLoS ONE. 2018;13(4):e0194453.CrossRefPubMedPubMedCentral Yamamoto T, Kaku M, Sumi H, Yashima Y, Izumino J, Tanimoto K. Effects of loxoprofen on the apical root resorption during orthodontic tooth movement in rats. PLoS ONE. 2018;13(4):e0194453.CrossRefPubMedPubMedCentral
36.
go back to reference Deng Y, Sun Y, Xu T. Evaluation of root resorption after comprehensive orthodontic treatment using cone beam computed tomography (CBCT): a meta-analysis. BMC Oral Health. 2018;18(1):116.CrossRefPubMedPubMedCentral Deng Y, Sun Y, Xu T. Evaluation of root resorption after comprehensive orthodontic treatment using cone beam computed tomography (CBCT): a meta-analysis. BMC Oral Health. 2018;18(1):116.CrossRefPubMedPubMedCentral
37.
go back to reference Li Y, Deng S, Mei L, Li Z, Zhang X, Yang C, et al. Prevalence and severity of apical root resorption during orthodontic treatment with clear aligners and fixed appliances: a cone beam computed tomography study. Prog Orthod. 2020;21(1):1.CrossRefPubMedPubMedCentral Li Y, Deng S, Mei L, Li Z, Zhang X, Yang C, et al. Prevalence and severity of apical root resorption during orthodontic treatment with clear aligners and fixed appliances: a cone beam computed tomography study. Prog Orthod. 2020;21(1):1.CrossRefPubMedPubMedCentral
38.
go back to reference Fang X, Qi R, Liu C. Root resorption in orthodontic treatment with clear aligners: A systematic review and meta-analysis. Orthod Craniofac Res. 2019;22(4):259–69.CrossRefPubMed Fang X, Qi R, Liu C. Root resorption in orthodontic treatment with clear aligners: A systematic review and meta-analysis. Orthod Craniofac Res. 2019;22(4):259–69.CrossRefPubMed
39.
go back to reference Pastro JDV, Nogueira ACA, Salvatore de Freitas KM, Valarelli FP, Cançado RH, de Oliveira RCG, et al. Factors Associated to Apical Root Resorption after Orthodontic Treatment. Open Dent J. 2018;12:331–9.CrossRefPubMedPubMedCentral Pastro JDV, Nogueira ACA, Salvatore de Freitas KM, Valarelli FP, Cançado RH, de Oliveira RCG, et al. Factors Associated to Apical Root Resorption after Orthodontic Treatment. Open Dent J. 2018;12:331–9.CrossRefPubMedPubMedCentral
41.
go back to reference Al-Tammami MF, Al-Nazhan SA. Retreatment of failed regenerative endodontic of orthodontically treated immature permanent maxillary central incisor: a case report. Restor Dent Endod. 2017;42(1):65–71.CrossRefPubMed Al-Tammami MF, Al-Nazhan SA. Retreatment of failed regenerative endodontic of orthodontically treated immature permanent maxillary central incisor: a case report. Restor Dent Endod. 2017;42(1):65–71.CrossRefPubMed
42.
go back to reference Ariffin SHZ, Din RDR, Yamamoto Z, Jaafar IM, Senafi S, Wahab RMA. External Apical Root Resorption as a Result of Orthodontic Treatment at Six and 12 Months. SAINS Malays. 2017;46(8):1299–307. Ariffin SHZ, Din RDR, Yamamoto Z, Jaafar IM, Senafi S, Wahab RMA. External Apical Root Resorption as a Result of Orthodontic Treatment at Six and 12 Months. SAINS Malays. 2017;46(8):1299–307.
Metadata
Title
Orthodontically induced external apical root resorption considerations of root-filled teeth vs vital pulp teeth: a systematic review and meta-analysis
Authors
Danning Zhao
Kun Xue
Jiayuan Meng
Meijing Hu
Fei Bi
Xuelian Tan
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-02982-4

Other articles of this Issue 1/2023

BMC Oral Health 1/2023 Go to the issue