Impact of intraoral non-pharmacological non-surgical adjunctive interventions on orthodontically induced inflammatory root resorption in humans: A systematic review

Background The current systematic review aimed to assess the impact of intraoral non-surgical non-pharmacological adjunctive interventions on orthodontically induced inflammatory root resorption (OIIRR). Search methods Search without restrictions was performed up to November 2020 in three electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE) for randomized controlled trials (RCTs), prospective and retrospective non-randomized studies. The ROB 2.0 tool was used to assess the quality of the included RCTs, and the ROBINS-I tool was applied to non-randomized clinical studies. The strength of evidence was ranked using GRADE. Results Three hundred and sixteen records were initially retrieved. A total of 10 studies, with 236 patients, were finally considered. These studies assessed the effects of mechanical vibration (low-frequency and high-frequency), low-intensity pulsed ultrasound (LIPUS), low-level laser therapy (LLLT) and photobiomodulation (light-emitting devices (LED). While the low-frequency vibration and LED do not seem to affect OIIRR, OIIRR has been reported to be reduced in high-frequency vibration, and LIPUS-treated teeth (differences may not likely be considered clinically relevant). The potential positive effect of LLLT on OIIRR is still debatable. Overall, the existing evidence suggests that the amount of OIIRR observed while using these interventions with traditional orthodontic treatment was not more than that was observed without it. Conclusions Based on a very low level of confidence, it seems that intraoral non-pharmacological non-surgical adjunctive interventions do not affect the amount of OIIRR either positively or negatively to a clinically relevant degree when compared to what is seen with conventional orthodontic treatment alone.