The interactive role of tooth trauma, pulpal status, and orthodontic tooth movement: A focused review

Aim: To address and highlight the changes that may occur during orthodontic tooth movement to both dental pulps and teeth, which have undergone various types of dental trauma and to address clinical concerns in the management of these teeth. Methods: Online search engines were used to access published journals along with hand searching available theses, along with any previously published in-depth review articles. Research findings and clinical relevance were considered with regards to levels of evidence or best evidence available. Results: There was a great deal of variability in the studies reviewed, which usually reflected the nature of the study protocols, patient populations and methods of treatment. The key findings, while minimally evidence-based, are summarised relevant to the best evidence available within a relationship that has received little recognition as to its existence. Conclusions: There are changes that occur within the dental pulp due to orthodontic tooth movement and these changes may be accentuated in teeth that have had previously varying degrees of trauma. Furthermore, traumatised teeth may undergo various degrees and types of root resorption that might impact on planned orthodontic and endodontic treatment procedures. Careful and thorough assessment of all teeth, particularly those that have a history of trauma is essential during the treatment planning for orthodontic tooth movement. Keywords: dental pulp, orthodontics, outcomes, symptomology, tooth trauma