Pulp Changes Secondary to Orthodontic Forces: A Review of Literature

Abstract

This review article encompasses the literature pertaining to changes in the dental pulp subsequent to forces exerted secondary to orthodontic treatment. The review was conducted at the College of Dentistry, Qassim University, Saudi Arabia, from October 2022 to February 2023. A literature search was conducted on PubMed, Embase, The Cochrane Library and Google Scholar for articles from 2000 to 2023. Keywords and MeSH terms used were ‘orthodontic forces’, ‘pulp changes’, ‘dental pulpal changes’, and ‘pulp volume’. Two reviewers went through the titles. After removing irrelevant and duplicate articles, abstracts were assessed for relevant articles. Finally, the reviewers analyzed full-text articles, and a total of five articles including four randomized controlled trials and one retrospective study were selected. It was concluded that managing and minimizing injury to the pulp or supporting tissues is important when using orthodontic mechanics. In order to do so, clinicians must thoroughly understand any change in the pulpal tissue following the orthodontic treatment. Orthodontic tooth movements cause inflammatory changes in the tooth pulp and periodontal ligament which are directly related to the amount, direction, and time duration of force used. Long-term pulp blood flow analysis shows that even though there is a transient uptrend in the flow of blood after the removal of the orthodontic force, it reverts to normal levels three months later. However, pulp volume has been reported to decrease, more prominently in anterior teeth, as orthodontic forces stimulate the pulp to produce tertiary dentin.

Recent progress in alleviating orthodontic discomfort: Mechanism and management-the state of evidence

“…Orthodontic discomfort and tooth movement are the result of a series of controlled inflammatory reactions involving cells, blood vessels, nerves, and the immune system. 16 These biological processes are connected, with local inflammation being the underlying reason. Pain is induced by the activation of sensory endings by the action of local inflammatory products, such as prostaglandin and bradykinin.…”

Orthodontics and Endodontics Clinical Practice Correlation: A Narrative Review

“…Orthodontic tooth movement could have multiple consequences on dental pulp. Studies have shown that orthodontic treatment could have a transient inflammatory response on dental pulp [ 1 ], external root resorption [ 2 ], and short-term dental pulp sensitivity [ 3 ], all of which and more should be considered before initiation of orthodontic tooth movement. Multiple factors influence the occurrence of complications during orthodontic tooth movement, such as forces used during movement of teeth [ 4 ].…”