Effect of Orthodontic Movement on the Periapical Healing of Teeth Undergone Endodontic Root Canal Treatment: A Systematic Review

Abstract

Background: The relationship between orthodontics and endodontics during the treatment planning phase is scarcely investigated, especially when orthodontic treatment is considered for endodontically treated teeth with apical periodontitis. This systematic review aimed to investigate the effect of orthodontic movement on the periapical healing of teeth that have undergone endodontic root canal treatment/retreatment. Materials and methods: On 15 March 2025, a systematic search was conducted in PubMed, Web of Science Core Collection, EBSCO host and complemented with a manual search of Google Scholar and the gray literature. The quality and the risk of bias of the included studies were assessed using the Joanna Briggs Critical Appraisal tools for human studies and the Systematic Review Centre for Laboratory Animal Experimentation for animal studies. The data about the influence of orthodontic movement on the periapical healing of endodontically treated teeth were extracted and pooled. Results: Out of 4614 identified titles, 6 studies were finally included (two animal and four clinical studies). The risk of bias was high in one study, moderate in three, and low in two. The included animal studies demonstrated a significant delay in the healing process of periapical lesions when orthodontic forces were applied shortly after root canal treatment. However, clinical studies showed no significant impact of orthodontic movement on periapical radiolucency except when the quality of obturation was compromised. Conclusions: Current clinical studies indicate that orthodontic tooth movement does not impair the periapical healing of endodontically treated teeth when the root canal obturation is of adequate quality.