Effects of systemic medication on root resorption associated with orthodontic tooth movement: a systematic review of animal studies

Summary Background Theoretically, root resorption could be modulated by any medication taken that exhibits possible effects on the implicated molecular pathways. Objectives To systematically investigate and appraise the quality of the available evidence from animal studies, regarding the effect of commonly prescribed systemic medication on root resorption associated with orthodontic tooth movement. Search methods Search without restrictions in eight databases (PubMed, Central, Cochrane Database of Systematic Reviews, SCOPUS, Web of Science, Arab World Research Source, ClinicalTrials.gov, ProQuest Dissertations and Theses Global) and hand searching until April 2018 took place. One author developed detailed search strategies for each database that were based on the PubMed strategy and adapted accordingly. Selection criteria Controlled studies investigating the effect of systemic medications on root resorption associated with orthodontic tooth movement. Data collection and analysis Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed using the SYRCLE’s Risk of Bias Tool. Results Twenty-one studies were finally identified, most of which at unclear risk of bias. Root resorption was shown to increase in Vitamin C treated animals in comparison with the control group, whereas a comparative decrease was noted after the administration of the alendronate, ibuprofen, growth hormone, low doses of meloxicam, simvastatin, lithium chloride and strontium ranelate. No difference was noted for acetaminophen, aspirin, fluoxetine, atorvastatin, misoprostol, zoledronic acid and zinc. Finally, inconsistent effects were observed after the administration of celecoxib, prednisolone and L-thyroxine. The quality of the available evidence was considered at best as low. Conclusions The pharmaceutical substances investigated were shown to exhibit variable effects on root resorption. Although the overall quality of evidence provides the clinician with a cautious perspective on the strength of the relevant recommendations, good practice would suggest that it is important to identify patients consuming medications and consider the possible implications. Registration PROSPERO (CRD42017078208)