Pain and root resorption due to surgical interventions to accelerate tooth movement in orthodontics: A systematic review and meta-analysis

Background. There are several publications that show the efficacy of surgical interventions in accelerating the rate of tooth movement in orthodontics. Consequently, possible adverse effects must also be evaluated. Objectives. The aim of the present study was to compare the perception of pain and root resorption between orthodontic treatment with a surgical acceleration intervention vs. conventional orthodontic treatment. Material and methods. An electronic search was conducted in the MEDLINE, Scopus, Web of Science (WoS), ScienceDirect, Cochrane Library, and Virtual Health Library (VHL) databases up to September 12, 2022. Randomized or non -randomized, controlled, parallel -arm or split -mouth clinical trials were included. Fixed -and random -effects meta -analyses were performed with regard to heterogeneity. The risk of bias (RoB) was assessed using the RoB 2.0 and ROBINS -I tools. Results. A total of 1,395 articles were initially retrieved, 40 studies were finally included in the review and 15 studies were eligible for quantitative analysis. The meta -analysis showed a significant difference in pain perception between acceleration surgery vs. conventional orthodontics at 24 h ( p = 0.040); however, this difference was not significant at 7 days ( p = 0.080). Overall, the patients who underwent any acceleration procedure presented significantly less resorption as compared to those who were applied conventional treatment ( p < 0.001). A similar significant difference was found in retraction movements ( p < 0.001) and alignment movements ( p = 0.030). Conclusions. In the first 24 h, surgical interventions for the acceleration of tooth movement produce a greater perception of pain as compared to conventional orthodontic treatment, but the perception is similar after 7 days. Acceleration surgery results in less root resorption - in alignment movements, and especially in retraction movements.