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Meta-Analysis
. 2025 May 20:84:275-283.
doi: 10.2340/aos.v84.43642.

Impact of fixed appliance treatment on root resorption in root canal-treated teeth: a systematic review and meta-analysis

Yongfang Feng  1 , Rong Wang  2 , Yumin Zhou  1 , Shengnan Zhan  3
Affiliations
Meta-Analysis

Impact of fixed appliance treatment on root resorption in root canal-treated teeth: a systematic review and meta-analysis

Yongfang Feng et al. Acta Odontol Scand. .

Abstract

Objective: The relationship between orthodontic treatment and root resorption in endodontically treated teeth remains controversial. This systematic review and meta-analysis aimed to evaluate the effects of fixed appliance treatment on root resorption in root canal-treated teeth compared to vital teeth.

Methods: A comprehensive literature search was conducted across multiple databases including PubMed, Embase, Cochrane Library, Web of Science, Sinomed, CNKI, and Wanfang. Studies comparing root resorption between root canal-treated teeth and vital teeth during orthodontic treatment were included. The methodological quality was assessed using the Cochrane risk of bias tool. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated using random-effects models.

Results: Ten studies involving 266 patients met the inclusion criteria. The overall effect showed no significant difference in root resorption between root canal-treated teeth and vital teeth (SMD = -0.08, 95% CI: -0.24 to 0.08, I² = 7.0%). Subgroup analyses revealed no significant differences based on measurement methods, extraction versus non-extraction treatment, or tooth position. However, extraction cases demonstrated a numerical trend toward greater root resorption in root canal-treated teeth (SMD = -0.70, 95% CI: -1.50 to 0.11, I² = 67.1%, p = 0.048), while the non-extraction group showed no meaningful differences (SMD = -0.07, 95% CI: -0.42 to 0.28, I² = 49.2%, p = 0.096).

Conclusions: This meta-analysis suggests that root canal-treated teeth do not show significantly different root resorption patterns compared to vital teeth during orthodontic treatment. However, extraction cases may require careful monitoring due to a tendency toward increased root resorption.

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Conflict of interest statement

All of the authors had no personal, financial, commercial, or academic conflicts of interest separately.

Figures

Figure 1
Figure 1
Study selection flow diagram.
Figure 2
Figure 2
Risk of bias graph.
Figure 3
Figure 3
Risk of bias summary.
Figure 4
Figure 4
Forest plot of overall effect.
Figure 5
Figure 5
Forest plot by measurement method.
Figure 6
Figure 6
Forest plot of extraction cases.
Figure 7
Figure 7
Forest plot of non-extraction cases.
Figure 8
Figure 8
Forest plot by tooth position.
See this image and copyright information in PMC

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