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Meta-Analysis
. 2023 Apr 25;23(1):241.
doi: 10.1186/s12903-023-02982-4.

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

Danning Zhao  1 , Kun Xue  1 , Jiayuan Meng  1 , Meijing Hu  2 , Fei Bi  3 , Xuelian Tan  4
Affiliations
Meta-Analysis

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

Danning Zhao et al. BMC Oral Health. .

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.

Keywords: Endodontic treatment; Orthodontic root resorption; Orthodontic treatment; Root-filled teeth.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A flow diagram of the study identification and selection process
Fig. 2
Fig. 2
Risk of bias assessment of the included studies. Deviation risk was assessed using deviation risk assessment tools from nonrandomized intervention studies. Bias was evaluated from five aspects: selection bias, performance bias, detection bias, attrition bias and reporting bias. Red indicates high risk, yellow indicates unclear risk, and green indicates low risk in the assessment results. This chart is derived from a review of the authors' selection of risk of bias items for each included study
Fig. 3
Fig. 3
Forest plot of orthodontic root resorption after endodontic treatment and vital pulp teeth. The results of the literature heterogeneity test showed large heterogeneity between studies, so a random effects model was used for analysis. The results of the main effect test showed that orthodontic root resorption of root-filled teeth was lower than that of vital pulp teeth. SD, standard deviation; IV, information value; 95% CI, 95% confidence interval
Fig. 4
Fig. 4
Results of dental subgroup analysis. The teeth were divided into two subgroups by anterior teeth and posterior teeth. Only in the posterior teeth group was the difference between root-filled teeth and vital pulp teeth in terms of the degree of orthodontic root resorption statistically significant. SD, standard deviation; IV, information value; 95% CI, 95% confidence interval
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