Katanaki Nefeli, Pouliezou Ioanna, Kerezoudis Nikolaos P, Sifakakis Iosif
Division of Orthodontics, University of Geneva, 1205 Geneva, Switzerland.
Medical Research Methodology Unit, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Healthcare (Basel). 2025 Sep 16;13(18):2311. doi: 10.3390/healthcare13182311.
: Clear aligners are increasingly prescribed for orthodontic treatment, primarily in adult patients; however, concerns have been raised that this treatment approach may negatively impact root length, especially in endodontically treated teeth. The present investigation aims to systematically synthesize available research addressing the potential effects of clear aligner orthodontic treatment on root length changes in endodontically treated teeth. : Four electronic databases were searched until May 2025, and lists of references from relevant publications were screened to identify studies (randomized clinical trials, controlled clinical trials, and observational studies) written in the English language with no date restriction. Clinical studies comparing clear aligner orthodontic treatment in endodontically treated teeth versus vital pulp teeth in humans, using cone beam computed tomography or panoramic radiographs to evaluate root resorption, were assessed. Following study selection and data extraction, the risk-of-bias assessment was evaluated with the Newcastle-Ottawa tool for the observational studies. : A total of 173 studies were retrieved, and ultimately 2 observational cohort studies were included in the systematic review, encompassing 135 patients (69.6% female; with an average age of 22.5 years). The present review found an association between endodontic status and root resorption, with vital pulp teeth (VPT) exhibiting a greater degree of resorption compared to root canal treated teeth (RCT). Clear aligner (CA) orthodontic treatment resulted in less root resorption than fixed orthodontic appliances (FAs). : Limited evidence indicates that clear aligner orthodontic treatment leads to a lower occurrence of root resorption and fewer cases of severe root resorption in endodontically treated teeth. Based on findings from studies comparing CAs to FAs, there is overall significantly greater resistance to root resorption in RCT than VPT, irrespective of the orthodontic treatment modality (CAs or FAs).
隐形矫治器越来越多地被用于正畸治疗，主要用于成年患者；然而，有人担心这种治疗方法可能会对牙根长度产生负面影响，尤其是在经过根管治疗的牙齿中。本研究旨在系统地综合现有研究，探讨隐形矫治器正畸治疗对根管治疗后牙齿牙根长度变化的潜在影响。
检索了四个电子数据库至2025年5月，并筛选了相关出版物的参考文献列表，以识别无日期限制的英文撰写的研究（随机临床试验、对照临床试验和观察性研究）。评估了比较人类根管治疗后牙齿与活髓牙的隐形矫治器正畸治疗的临床研究，使用锥形束计算机断层扫描或全景X线片评估牙根吸收情况。在研究选择和数据提取后，使用纽卡斯尔-渥太华工具对观察性研究进行偏倚风险评估。
共检索到173项研究，最终2项观察性队列研究被纳入系统评价，涵盖135名患者（69.6%为女性；平均年龄22.5岁）。本综述发现根管治疗状态与牙根吸收之间存在关联，活髓牙（VPT）比根管治疗牙（RCT）表现出更高程度的吸收。隐形矫治器（CA）正畸治疗导致的牙根吸收比固定正畸矫治器（FAs）少。
有限的证据表明，隐形矫治器正畸治疗导致根管治疗后牙齿的牙根吸收发生率较低，严重牙根吸收的病例较少。基于比较CA与FA的研究结果，无论正畸治疗方式（CA或FA）如何，RCT对牙根吸收的总体抵抗力明显高于VPT。
