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Orthodontics

Pulp fiction or pulp fact—does orthodontics damage pulpal tissue?

Evidence-Based Dentistry volume 24, pages 39–40 (2023)Cite this article

Subjects

Abstract

Data sources

Electronic databases PubMed, Scopus and Embase were systematically searched and restricted to articles published between February 2009 and 2022.

Study selection

Studies were categorized using the modified method by the Swedish Council of Technology Assessment in Health Care. 20 studies were included, one of which was categorized as high quality (Grade A) and 19 of which were of moderate quality (Grade B). Exclusion criteria included articles with insufficient descriptions of reliability and reproducibility testing, review articles and case reports, and studies including traumatised teeth.

Data extraction and synthesis

Three independent authors examined titles, abstracts and full texts of relevant articles against the inclusion criteria. Disagreements were resolved by discussion. Retrieved studies were assessed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data extracted included tooth movement performed, the appliance and force used, follow-up of subjects, changes in pulpal blood flow (PBF), tooth sensibility, expression of inflammation-related proteins, along with pulpal histology and morphology changes during tooth movement (intrusion, extrusion and tipping). Overall risk of bias was unclear.

Results

A reduction in pulpal blood flow and tooth sensibility due to the application of orthodontic forces was reported by studies included in the review. Increases in the activity of proteins and enzymes related to inflammation of the pulp was reported. Two studies reported histological changes of the pulpal tissues related to orthodontic treatment.

Conclusions

Orthodontic forces cause multiple temporary detectable changes in the dental pulp. The authors conclude there are no clear signs of permanent pulpal damage to healthy teeth due to the application of orthodontic forces.

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Author information

Authors and Affiliations

  1. Department of Restorative Dentistry, Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow, UK

    Helen Fegan

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  1. Helen Fegan
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Correspondence to Helen Fegan.

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The author declares no competing interests.

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Fegan, H. Pulp fiction or pulp fact—does orthodontics damage pulpal tissue?. Evid Based Dent 24, 39–40 (2023). https://doi.org/10.1038/s41432-023-00871-x

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  • DOI: https://doi.org/10.1038/s41432-023-00871-x

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