Orthodontic root resorption associated with surgical adjunctive procedures for accelerating tooth movement: a systematic review of randomised controlled trials

Intervention	No. of participants (studies)	Risk of bias	Inconsistency	Indirectness	Imprecision	Publication bias	Effect	Overall quality of evidence
Corticotomy (piezocision)	143 (6 RCTs)	Unclear	No	Serious^#	Serious^†	Not suspected	A single study showed an increase in resorption	LOW
Corticotomy (corticision)	52 (1 RCT)	Low	No	No	Serious^†	Not suspected	Failed to demonstrate increased resorption	LOW
Corticotomy (traditional)	40 (2 RCT)	Serious^*	No	No	Serious^†	Not suspected	A single study showed an increase in resorption	LOW
MOPs	125 (6 RCTs)	Low	No	Serious^#	Serious^†	Not suspected	A single study showed both an increase and decrease in resorption	LOW

Search strategy for PubMed.

Search	Search term	Results
1	exp Orthodontics/	83,695
2	orthodontic*.mp.	76,962
3	braces.mp.	12,605
4	1 OR 2 OR 3	96,104
5	exp Tooth Resorption/	8,911
6	resorp* or resorb*	72,843
7	root AND (erosion OR shortening OR blunting OR length).mp.	19,798
8	5 OR 6 OR 7	92,085
9	exp Randomized Controlled Trial/	694,278
10	randomized controlled trial’ OR ‘randomised controlled trial’	565,492
11	rct.mp.	25,824
12	9 OR 10 OR 11	703,071
13	4 AND 8 AND 12	130

Outcomes of Included Studies.

Study	Year	Effect of SAPATM on OIERR	Secondary Outcomes of SAPATM
Abbas et al.²⁹	2016	Reduced OIERR	Increased canine crown tipping^*
Aboalnaga et al.³⁰	2019	No significant difference	Increased canine tip movementIncreased canine centre and apex movement^*
Alkasaby et al.³¹	2022	Increased OIERR for mesiobuccal roots^*Reduced OIERR for distobuccal roots^#	Increased molar distalisation^# Decreased bone density in the middle and apical thirds of root length^#
Alkebsi et al.³²	2018	Reduced OIERR	No significant difference
Alqadasi et al.³³	2020	Reduced OIERR	Increased overall net movement of teethDecreased canine palatal bone height^*
Charavet et al.³⁴	2016	No significant difference	Reduced treatment time^# Patient satisfaction^*
Chavaret et al.³⁵	2019	No significant difference	Reduced treatment time^Decreased time to archwire change^Patient satisfaction^*
Hatrom et al.³⁶	2021	Reduced OIERR	No significant difference
Raj et al.³⁷	2020	No significant difference	Increased rate of tooth retraction^# Decrease in relative attachment level^*
Shahrin, Abdul Ghani & Norman.³⁸	2021	No significant difference	Nil assessed
Sirri et al.³⁹	2021	No significant difference	Reduced treatment time^#
Shoreibah et al.⁴⁰	2012	Reduced OIERR^*	Reduced treatment time^*Lower decrease in bone density
Thomas et al.⁴¹	2021	No significant difference	Increased initial tooth movement^#

Characteristics of Included Studies.

Study (Year)	Study design	Participants	Treatment Goal	Intervention + Comparison	Outcomes	Diagnostic modality	Follow-up
Abbas et al. (2016)²⁹	RCT, SMD, parallel	20 patients (gender not stated); ages 15–25 y; mean age not stated	Orthodontic canine retraction with NiTi closed coil spring (150 mg)	G1: Corticotomy + Orthodontic retractionG2: Piezocision + Orthodontic retractionCo: Conventional orthodontic treatment	– Change in root length – Change in root angulation – Antero-posterior crown tip movement	CBCT	12 weeks
Aboalnaga et al. (2019)³⁰	RCT, SMD, parallel	18 patients (18 F, 0 M); ages, 16–30 y; mean, 20.5 ± 3.85 y	Orthodontic canine retraction (after first premolar extraction) with TADs and NiTi closed coil spring (150 g)	G1: Flapless MOPs + Orthodontic treatmentCo: Conventional orthodontic treatment	– Canine root resorption – Rate of canine retraction – Total distance canine movement – Effect of MOPs on anchorage loss – Pain	CBCT	16 weeks (4 months)
Alkasaby et al. (2022)³¹	RCT, parallel	20 patients (20 F, 0 M); ages, 16–20 y; mean, 18.05 ± 1.15 y	En-masse distalisation of maxillary molars with miniscrew-supportedFast-Buck appliance via closed coil spring (300 g)	G1: Flapless MOPs + Orthodontic treatmentCo: Conventional orthodontic treatment	– Root resorption – Alveolar bone density – Rate of tooth movement	CBCT	No specific time statedAll participants followed up until distalisation (2.9–3 mm) achieved
Alkebsi et al. (2018)³²	RCT, SMD, parallel	32 patients (24 F, 8 M); ages, 16–24 y; mean, 19.26 ± 2.48 y	Orthodontic canine retraction (after upper first premolar extraction) with miniscrews and NiTi closed coil spring (150 g)	G1: Flapless MOPs + Orthodontic treatmentCo: Conventional orthodontic treatment	– Root resorption – Rate of canine retraction, canine rotation – Periodontal index, gingival index & anchorage loss – Pain level, satisfaction, degree of ease, willingness to repeat & recommendation to others	IOPA	12 weeks (3 months)
Alqadasi et al. (2020)³³	RCT, SMD, parallel	21 patients (12 F, 9 M); ages, 15–40 y; mean, 20.89 ± 4.46 y	Orthodontic canine retraction (after first premolar extraction) with TADs and NiTi closed coil spring (150 g)	G1: Flapless MOPs + Orthodontic treatmentG2: Piezocision + Orthodontic treatmentCo: Conventional orthodontic treatment	– Root resorption – Rate of canine retraction – Buccal + palatal bone height	CBCT	12 weeks (3 months)
Charavet et al. (2016)³⁴	RCT, parallel	32 patients (15 F, 9 M); ages, 21–39 y; mean, 30 y	Orthodontic alignment and finishing of maxillary and mandibular dentition with copper NiTi and stainless steel archwires	G1: Piezocision + Orthodontic treatmentCo: Conventional orthodontic treatment	– Change in root length – Treatment duration – Alveolar cortical plate thickness, dehiscence and fenestration, recession, probing depth, plaque index, papillary bleeding, scarring – Pain, satisfaction, patient apprehension	Computed Tomography	G1: 44.3 weeksCo: 77.9 weeks
Chavaret et al. (2019)³⁵	RCT, parallel	24 patients (15F, 9M); ages (21 – 37y; mean 27.9y	Orthodontic alignment and finishing (with copper NiTi and stainless steel archwires) of maxillary and mandibular dentition into Class I occlusion	G1: Piezocision + CAD/CAM orthodontic appliancesCo: CAD/CAM orthodontic appliances	– Root resorption – Orthodontic treatment duration, cumulate time to archwire change, time of fine tuning phase – Recession depth, pocket depth, dehiscence and fenestration, plaque index, papilla bleeding, gingival scars, bone healing	CBCT	No specific time statedAll participants followed up until Class I occlusion achieved
Hatrom et al. (2021)³⁶	RCT, parallel	26 patients (13 F, 13M); 16–26y, mean G1: 19.27y, Co: 20.83	En-masse retraction of maxillary anterior teeth (after first premolar extraction) with NiTi closed coil spring (250 g)	G1: Piezocision + Extraction + Orthodontic treatmentCo: Extraction + Conventional orthodontic treatment	– Change in root length – Pulp volume	CBCT	17.5 weeks (122.74 ± 3.06 days)
Raj et al. (2020)³⁷	RCT, SMD, parallel	20 patients (14 F, 6 M); 20 – 25y, mean 23.18y	Orthodontic canine retraction with NiTi closed coil spring (150 g)	G1: Piezocision + Orthodontic treatmentCo: Conventional orthodontic treatment	– Change in root length – Probing depth, relative attachment level	CBCT	26 weeks (6 months)
Shahrin, Abdul Ghani & Norman (2021)³⁸	RCT, SMD, parallel	30 patients (25 F, 5 M); ages, 18–45 y; mean, 22.66 ± 3.27 y	Orthodontic alignment of maxillary and mandibular dentition with NiTi archwires	G1: Flapless MOPs + Orthodontic treatmentCo: Conventional orthodontic treatment	– Root resorption	IOPA	26 weeks (6 months)
Sirri et al. (2021)³⁹	RCT, Parallel	52 patients (38 F, 14 M); ages, 18–24 y; mean, 21.38 y	Orthodontic levelling and alignment with NiTi and stainless steel archwires	G1: Flapless Corticision + Orthodontic treatmentCo: Conventional orthodontic treatment	– Root resorption – Dehiscence formation	CBCT	No specific time stated
Shoreibah et al. (2012)⁴⁰	RCT, parallel	20 patients (17F, 3M); 18.4–25.6y, mean	Orthodontic anterior levelling, alignment and finishing of mandibular dentition with NiTi and stainless steel archwires	G1: Corticotomy + Orthodontic treatmentCo: Conventional orthodontic treatment	– Change in root length – Canine movement rate – Pocket depth, bone density, marginal bone level	IOPA	G1: 17.5 weeksCo: 49 weeks
Thomas et al. (2021)⁴¹	RCT, SMD, parallel	33 patients (24 F, 9 M); ages, 19–25 y; mean, 22.1 ± 2.19 y	Orthodontic canine retraction (after first premolar extraction) with TADs and NiTi closed coil spring (150 g)	G1: Flapless MOPs + Orthodontic treatmentCo: Conventional orthodontic treatment	– Canine movement rate and tipping – Change in root length – Probing depth, relative attachment level	CBCT	12.86 weeks (90 days)

eISSN:: 2207-7480
Sprache:: Englisch

Zeitrahmen der Veröffentlichung:: Volume Open
Fachgebiete der Zeitschrift:: Medizin, Vorklinische Medizin, Grundlagenmedizin, andere

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Orthodontic root resorption associated with surgical adjunctive procedures for accelerating tooth movement: a systematic review of randomised controlled trials

Online veröffentlicht: 06. Juli 2022

Seitenbereich: 237 - 251

Eingereicht: 01. Apr. 2022

Akzeptiert: 01. Mai 2022

DOI: https://doi.org/10.2478/aoj-2022-0020

© 2022 Khilan Shukla et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1.

Figure 2.

GRADE Summary of Findings: Effect of Surgical Adjunctive Procedures Accelerating Tooth Movement on Root Resorption.

Search strategy for PubMed.

Outcomes of Included Studies.

Characteristics of Included Studies.