Orthodontics and Endodontics: clinical decision-making

Abstract

Endodontically treated teeth may be moved, as endodontic treatment is not a contraindication for orthodontic treatment. Apical periodontal repair begins when the periapical or pulp lesion has completely resolved. This may happen immediately after treatment if the filling material causes little or no irritation of periapical tissues, and particularly if the material is fully contained within the canal. When it leaks, a foreign body granuloma forms and persists for some months or indefinitely, depending on the composition of the filling material. Materials containing calcium hydroxide with no resin components undergo phagocytosis and disappear in some months, as macrophages gradually remove them. Materials containing resins, silicone, ionomers, zinc oxide-eugenol, bioceramics or gutta-percha remain in the site and induce the formation of foreign body granulomas. Although this does not preclude tooth movement, patients should be followed up every three months using periapical images to control the position of the material in relation to the tooth apex. “Pseudo” overfilling may be avoided if permanent filling is delayed until the time when orthodontic treatment is completed.

Orthodontically induced external apical root resorption considerations of root-filled teeth vs vital pulp teeth: a systematic review and meta-analysis

“…Lee and Castro et al confirmed that EARR was significantly greater in RFT with periapical pathosis before orthodontic treatment from a controlled clinical study [ 23 , 39 ], which indicated that the EARR of RFT is related to the healing degree of periapical lesions after root canal therapy. Consolaro et al suggested that force can be applied within a few days after endodontic treatment if the treated tooth has no periapical lesions or inflammatory periapical lesions [ 40 ]. Al-Tammami et al suggested that if there is significant periapical radiolucency, orthodontic treatment should be delayed 6 months until radiographic evidence of healing appears [ 41 ].…”

“…According to Consolaro et al and Pustułka et al, teeth with mild trauma and an intact periodontal membrane may require a waiting period of 3-4 months to allow for the restoration of normal periodontal tissue and structure before orthodontic movement is initiated. This waiting period is necessary to prevent potentially adverse effects on the healing process and minimize the risk of further damage to the traumatized tooth [11,40]. Moderately traumatized teeth require a waiting period of at least 1 year until periapical radiography and/or tomography shows normalized results.…”

Orthodontic Treatment under Endodontic Consideration Based on Orthodontic Root Resorption: A Systematic Review and Meta-analysis

“…For the traumatized tooth, Consolaro et al and Pustułka et al considered that teeth with mild injury and an intact periodontal membrane may need to wait 3-4 months until the assessed periodontal tissue and structure return to normal before orthodontic moving (9,37). Moderately traumatized teeth must wait for 1 year until periapical radiography and/or tomography are normal.…”

“…Lee and Castro et al con rmed that ORR was signi cantly greater in RFT with periapical pathosis before orthodontic treatment from a controlled clinical study (23,42), which indicated that the ORR of RFT is related to the healing degree of periapical lesions after root canal therapy. Consolaro et al suggested that force can be applied within a few days after endodontic treatment if the treated tooth has no periapical lesions or in ammatory periapical lesions (37). Al-Tammami et al suggested that if there is signi cant periapical radiolucency, orthodontic treatment should be delayed 6 months until radiographic evidence of healing appears (38).…”

Factors to Be Considered in Orthodontic Interdisciplinary Approach – A Review

“…Once a root canal treatment has been completed but subsequently fails after orthodontic tooth movement, the orthodontic movement should not be blamed for this failure. The failure should be investigated by the other team members to find the causative factor [14] . Some orthodontic procedures might give rise to endodontic complications.…”