Under pressure-mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review.
Journal
European journal of orthodontics
ISSN: 1460-2210
Titre abrégé: Eur J Orthod
Pays: England
ID NLM: 7909010
Informations de publication
Date de publication:
18 09 2023
18 09 2023
Historique:
medline:
19
9
2023
pubmed:
27
6
2023
entrez:
27
6
2023
Statut:
ppublish
Résumé
The application of orthodontic forces causes root resorption of variable severity with potentially severe clinical ramifications. To systematically review reports on the pathophysiological mechanisms of orthodontically induced inflammatory root resorption (OIIRR) and the associated risk factors based on in vitro, experimental, and in vivo studies. We undertook an electronic search of four databases and a separate hand-search. Studies reporting on the effect of orthodontic forces with/without the addition of potential risk factors on OIIRR, including (1) gene expression in in-vitro studies, the incidence root resorption in (2) animal studies, and (3) human studies. Potential hits underwent a two-step selection, data extraction, quality assessment, and systematic appraisal performed by duplicate examiners. One hundred and eighteen articles met the eligibility criteria. Studies varied considerably in methodology, reporting of results, and variable risk of bias judgements.In summary, the variable evidence identified supports the notion that the application of orthodontic forces leads to (1) characteristic alterations of molecular expression profiles in vitro, (2) an increased rate of OIIRR in animal models, as well as (3) in human studies. Importantly, the additional presence of risk factors such as malocclusion, previous trauma, and medications like corticosteroids increased the severity of OIIRR, whilst other factors decreased its severity, including oral contraceptives, baicalin, and high caffeine. Based on the systematically reviewed evidence, OIIRR seems to be an inevitable consequence of the application of orthodontic forces-with different risk factors modifying its severity. Our review has identified several molecular mechanisms that can help explain this link between orthodontic forces and OIIRR. Nevertheless, it must be noted that the available eligible literature was in part significantly confounded by bias and was characterized by substantial methodological heterogeneity, suggesting that the results of this systematic review should be interpreted with caution. PROSPERO (CRD42021243431).
Sections du résumé
BACKGROUND
The application of orthodontic forces causes root resorption of variable severity with potentially severe clinical ramifications.
OBJECTIVE
To systematically review reports on the pathophysiological mechanisms of orthodontically induced inflammatory root resorption (OIIRR) and the associated risk factors based on in vitro, experimental, and in vivo studies.
SEARCH METHODS
We undertook an electronic search of four databases and a separate hand-search.
SELECTION CRITERIA
Studies reporting on the effect of orthodontic forces with/without the addition of potential risk factors on OIIRR, including (1) gene expression in in-vitro studies, the incidence root resorption in (2) animal studies, and (3) human studies.
DATA COLLECTION AND ANALYSIS
Potential hits underwent a two-step selection, data extraction, quality assessment, and systematic appraisal performed by duplicate examiners.
RESULTS
One hundred and eighteen articles met the eligibility criteria. Studies varied considerably in methodology, reporting of results, and variable risk of bias judgements.In summary, the variable evidence identified supports the notion that the application of orthodontic forces leads to (1) characteristic alterations of molecular expression profiles in vitro, (2) an increased rate of OIIRR in animal models, as well as (3) in human studies. Importantly, the additional presence of risk factors such as malocclusion, previous trauma, and medications like corticosteroids increased the severity of OIIRR, whilst other factors decreased its severity, including oral contraceptives, baicalin, and high caffeine.
CONCLUSIONS
Based on the systematically reviewed evidence, OIIRR seems to be an inevitable consequence of the application of orthodontic forces-with different risk factors modifying its severity. Our review has identified several molecular mechanisms that can help explain this link between orthodontic forces and OIIRR. Nevertheless, it must be noted that the available eligible literature was in part significantly confounded by bias and was characterized by substantial methodological heterogeneity, suggesting that the results of this systematic review should be interpreted with caution.
REGISTRATION
PROSPERO (CRD42021243431).
Identifiants
pubmed: 37366151
pii: 7208182
doi: 10.1093/ejo/cjad011
pmc: PMC10505745
doi:
Types de publication
Systematic Review
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
612-626Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Orthodontic Society.
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