ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title No Increased Risk of Root Resorption of Endodontically Treated Teeth During Orthodontic Treatment
Clinical Question In patients with endodontically treated teeth undergoing orthodontic treatment, compared to those without endodontically treated teeth, is it necessary to alter treatment to prevent apical root resorption?
Clinical Bottom Line External root resorption for endodontically treated teeth and vital teeth during orthodontic treatment are statistically the same.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 2301299Spurrier/1990N=43 (one or more endodontically treated teeth)Split Mouth Study
Key resultsVital incisors resorbed to a significantly greater degree than endodontically treated incisors (p < 0.05). Endodontically treated incisors resorb with less frequency and severity than vital control teeth. No significant difference in root resorption between male and female patients in endodontically treated incisors. Control teeth exhibited significantly more resorption in male patients than in female patents. Even though statistical significance was noted, clinical differences are minimal when endodontically treated and vital incisors are compared.
#2) 23064975Ioannidou-Marathiotou/20126 out of 1,942 papers; n=107 experimental, 107 control teethMeta-Analysis
Key resultsRoot resorption was significantly less in endodontically treated teeth than in vital teeth and the pooled mean difference (MD) of root resorption between these two groups was −0.48 mm (95 % CI = −0.81 to −0.14 mm; P = 0.005), although this difference (−0.48 mm) might be considered of little clinical importance. Following orthodontic treatment, endodontically treated teeth exhibit relatively less root resorption than teeth with vital pulps, although the overall amount of this resorption might be of little clinical importance. Clinicians should consider orthodontic movement of endodontically treated teeth as a relatively safe clinical procedure.
#3) 20456512Llamas-Carreras/2010N=77 patients with one or more endodontically treated tooth before completion of orthodontic treatment.Split Mouth Study
Key resultsThere was no significant difference in the amount or severity of external root resorption during orthodontic movement between root filled teeth and their contralateral healthy controls (PRR 1.00+/-0.13). However, when comparing incisors to other teeth the amount of resorption was statistically greater in incisors (P=0.0014: odds ratio = 6.2885, C.I. 95 = 2.0-19.4).
#4) 2301299Esteves/2007N= 16 patients who had a maxillary central incisor treated endodontically before initiation of the orthodontic movement, and a vital homologous tooth (for control). Split Mouth Study
Key resultsThere was no significant difference in apical root resorption, observed radiographically, in endodontically treated and untreated teeth subjected to orthodontic movement. However, the apical root resorption found in the group of vital teeth was highly significant (p = 0.0004), compared with the group of endodontically treated teeth (p = 0.007).
Evidence Search PubMed search; “Endodontic and orthodontic treatment” [MeSH], "Apical root resorption" [MeSH], "Orthodontic movement of endodontically treated teeth" [MeSH]
Comments on
The Evidence
Numerous research articles detail clinical trials on orthodontically moving endodontically treated teeth. The articles selected represent the most accurate and relevant articles.
Applicability Applicable to providers providing orthodontic movement of endodontic treated teeth. Clinicians should consider orthodontically moving endodontically treated teeth as a safe clinical procedure. Clinicians should take into consideration that active orthodontic treatment does cause external root resorption.
Specialty/Discipline (Endodontics) (General Dentistry) (Orthodontics)
Keywords Apical resorption; endodontic; orthodontic treatment; root resorption, External apical root resorption, Systematic review, Meta-analysis
ID# 2714
Date of submission: 05/09/2014spacer
E-mail Cameron.lamb@ucdenver.edu
Author Cameron Lamb
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ethelyn Thomason, DMD
Faculty mentor/Co-author e-mail ethelyn.thomasonlarsen@ucdenver.edu
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