J Am Dent Assoc. 2022 Jun;153(6):532-541.e7. doi: 10.1016/j.adaj.2021.11.012. Epub 2022 Mar 11.
In this systematic review, the authors aimed to answer the following question: Do vital teeth differ in the level of external root resorption induced by means of orthodontic treatment compared with root-filled teeth?
The search strategy was performed in 6 electronic databases and in gray literature for articles published until July 29, 2021. Two reviewers independently assessed potentially eligible studies according to the following criteria: studies that evaluated patients undergoing fixed orthodontic therapy and compared the mean difference in millimeters of orthodontically induced external root resorption in endodontically treated teeth with the vital contralateral tooth. Only randomized, quasi-randomized, nonrandomized, cohort, case-control, or cross-sectional studies were considered eligible. There were no restrictions on language or publication time. Two reviewers also independently extracted data on the characteristics of the included studies, methods, and results, and performed risk-of-bias analysis using the Meta-Analysis of Statistics Assessment and Review instrument. Estimates of interest were calculated using random-effects meta-analyses. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.
Eleven studies were included in the quantitative synthesis. Endodontically treated teeth had a lower level of root resorption (mean difference, 0.45 mm; 95% CI, -0.69 to -0.21 mm). However, the level of certainty of the evidence was considered very low owing to confounding factors.
Endodontically treated teeth may have a lower level of orthodontically induced root resorption than vital teeth, but the evidence is still uncertain about this outcome. Furthermore, owing to the small effect size, this difference might not be clinically significant (up to 1 mm).
在这项系统评价中，作者旨在回答以下问题：与活髓牙相比，接受正畸治疗的恒牙在外部牙根吸收程度上是否存在差异？
检索策略在 6 个电子数据库和灰色文献中进行，检索截至 2021 年 7 月 29 日发表的文章。两位评审员根据以下标准独立评估了潜在合格的研究：评估接受固定正畸治疗的患者，并比较经牙髓治疗的牙齿和对侧活髓牙的正畸诱导的外部牙根吸收的平均差异毫米数。只有随机、准随机、非随机、队列、病例对照或横断面研究被认为是合格的。语言或出版时间没有限制。两位评审员还独立提取了纳入研究的特征、方法和结果的数据，并使用 Meta 分析的统计评估和审查工具进行了偏倚风险分析。使用随机效应荟萃分析计算感兴趣的估计值。证据的确定性使用推荐评估、制定和评估工具进行评估。
有 11 项研究被纳入定量综合分析。牙髓治疗的牙齿的牙根吸收程度较低（平均差异，0.45 毫米；95%置信区间，-0.69 至-0.21 毫米）。然而，由于混杂因素的存在，证据的确定性水平被认为非常低。
与活髓牙相比，牙髓治疗的牙齿可能具有较低水平的正畸诱导的牙根吸收，但关于这一结果的证据仍然不确定。此外，由于效应量较小，这种差异可能在临床上并不显著（最多 1 毫米）。
