Effect of orthodontic forces on human dental pulp: A systematic review

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Kanok-on Tantipanichkul
Kanin Nimcharoensuk
Suwannee Luppanapornlarp
Nathaphon Tangjit


Introduction: Orthodontic force application stimulates a biological response of the dental pulp.  The pulpal response to orthodontic force involves cell damage, inflammation, and wound healing.  The pulpal reparation rate, pulpal obliteration by secondary dentin formation, root resorption, and pulpal necrosis have all been associated with orthodontic treatment

Objective: The aim of this systematic review was to investigate the influence of orthodontic force on human pulpal reaction.

Methods: Electronic search was made until July 15, 2016.  Additional studies were identified by hand search of reference list of relevant articles from the electronic search.  Search terms were the following keywords: “orthodontic force”, “tooth movement”, orthodontic treatment”, “pulpal blood flow”, “vitality loss”, “necrosis”, “pulpal reaction”, “pulpal cellular response”, “pulpal alteration”, and “inflammatory response”.  Two independent reviewers assessed the eligibility for inclusion, extracted the data, apply quality indicators, and grade level of evidence.

Results: Forty-one studies matched the inclusion criteria.  The outcome concerned the effect of orthodontic force on pulpal blood flow (PBF) in 9 studies, the influence of orthodontic force on human pulpal cellular responses in 23 studies, and the pulpal reaction of orthodontic force on previously traumatized teeth in 5 studies.

Conclusion: There is a lack of high-quality scientific evidence to prove that orthodontic forces affect in alteration of human dental pulp.  However, applying orthodontic force on traumatized teeth is considered a risk factor for vitality loss of dental pulp.


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Tantipanichkul K- on, Nimcharoensuk K, Luppanapornlarp S, Tangjit N. Effect of orthodontic forces on human dental pulp: A systematic review. M Dent J [Internet]. 2020 Oct. 21 [cited 2023 Dec. 2];37(2):243-62. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/246860
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