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Under pressure—mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review

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 assoc...

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Autores principales: Dawood, Hassan M, Kroeger, Annika, Chavda, Vinay, Chapple, Iain L C, Kebschull, Moritz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505745/
https://www.ncbi.nlm.nih.gov/pubmed/37366151
http://dx.doi.org/10.1093/ejo/cjad011
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author Dawood, Hassan M
Kroeger, Annika
Chavda, Vinay
Chapple, Iain L C
Kebschull, Moritz
author_facet Dawood, Hassan M
Kroeger, Annika
Chavda, Vinay
Chapple, Iain L C
Kebschull, Moritz
author_sort Dawood, Hassan M
collection PubMed
description 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).
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spelling pubmed-105057452023-09-19 Under pressure—mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review Dawood, Hassan M Kroeger, Annika Chavda, Vinay Chapple, Iain L C Kebschull, Moritz Eur J Orthod Systematic Reviews 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). Oxford University Press 2023-06-27 /pmc/articles/PMC10505745/ /pubmed/37366151 http://dx.doi.org/10.1093/ejo/cjad011 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Orthodontic Society https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Systematic Reviews
Dawood, Hassan M
Kroeger, Annika
Chavda, Vinay
Chapple, Iain L C
Kebschull, Moritz
Under pressure—mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review
title Under pressure—mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review
title_full Under pressure—mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review
title_fullStr Under pressure—mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review
title_full_unstemmed Under pressure—mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review
title_short Under pressure—mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review
title_sort under pressure—mechanisms and risk factors for orthodontically induced inflammatory root resorption: a systematic review
topic Systematic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505745/
https://www.ncbi.nlm.nih.gov/pubmed/37366151
http://dx.doi.org/10.1093/ejo/cjad011
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