The effect of orthodontic tooth movement on the sensitivity of dental pulp: A systematic review and meta-analysis

A Golež; M Ovsenik; K Cankar

doi:10.1016/j.heliyon.2023.e14621

The effect of orthodontic tooth movement on the sensitivity of dental pulp: A systematic review and meta-analysis

Heliyon. 2023 Mar 24;9(4):e14621. doi: 10.1016/j.heliyon.2023.e14621. eCollection 2023 Apr.

Authors

A Golež^{1

2}, M Ovsenik^{2

3}, K Cankar¹

Affiliations

¹ University of Ljubljana, Faculty of Medicine, Institute of Physiology, Zaloska Cesta 4, Ljubljana, Slovenia.
² Orthos Institute, Vilharjev podhod 18, Ljubljana, Slovenia.
³ University of Ljubljana, Faculty of Medicine, Department of Orthodontics and Dentofacial Orthopaedics, Hrvatski trg 6, Ljubljana, Slovenia.

Abstract

Objectives: Orthodontic tooth movement (OTM) is a process that's initiated by orthodontic forces. As a consequence, the forces could restrict pulpal blood supply, possibly affecting dental pulp. The study aimed to review the available evidence on the short and long-term effects of orthodontic tooth movement on dental pulp sensitivity and to identify clinically relevant risk factors.

Sources: PubMed, Embase, Scopus, and Web of Science were searched for papers from 1990 to the end of December 2021.

Study selection: The studies that evaluated dental pulp sensitivity of teeth undergoing OTM were included in the systematic review. Randomized, nonrandomized and case-controlled studies were included in the analysis. Risk of bias in each study was assessed using the ROBINS-I tool.

Data: The systematic search yielded an initial sample of 1110 studies, 17 were included in qualitative analysis. Most studies were classified as moderate risk of bias, however only limited long-term evidence with a higher risk of bias exists. Electric pulp test (EPT) sensitivity threshold during active OTM was increased by 4.25 SD (P < 0.001) and the relative risk (RR) of pulpal non-sensitivity was 13.27 (P < 0.001) higher compared to pre-orthodontic baseline status. Significant differences were between subgroups associated with the type of OTM. A positive relationship between pulpal non-sensitivity and mean patient age was discovered (P = 0.041). After OTM the risk of pulpal non-sensitivity remained 5.76 times higher (P < 0.001) in the long term.

Conclusions: Evidence showed that OTM could affect dental pulp sensitivity. The type of OTM and patients' age were identified as clinically relevant risk factors.

Clinical significance: Orthodontic tooth movement negatively impacts the sensitivity of dental pulp during active treatment and to a lesser degree in the long term. Pulpal sensitivity tests during active OTM should therefore be interpreted with caution. Data indicates younger patients have a lower risk of negative pulpal sensitivity during orthodontic treatment.

Keywords: Dental pulp; Dental pulp test; Orthodontic tooth movement; Tooth movement techniques.