SynthesisPloS one2026
Does invasive surgical acceleration of orthodontic tooth movement increase root resorption? A harms-focused systematic review.
Synthesis in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOrthodontically induced root resorption (RR) is frequent, and invasive surgically accelerated orthodontic (ISAO) procedures may increase it. This study aimed to assess the effect of ISAO on RR in teeth adjacent to surgically treated segments compared with conventional orthodontic treatment.
methodsFollowing PRISMA, five major databases and four grey literature sources were searched through August 2025 without language or date restrictions. Eligible studies were randomized controlled trials and comparative non-randomized intervention studies, including split-mouth designs, that reported quantitative root resorption after flap-based procedures. Two reviewers independently selected studies, extracted data, and assessed risk of bias using RoB 2 and ROBINS-I. Root resorption ascertainment and harms reporting were appraised with a modified McMaster Harms tool, and certainty was evaluated with GRADE. The review was registered in PROSPERO (CRD420251166274).
resultsEleven studies involving 352 patients were included. Because of substantial heterogeneity in surgical protocols, imaging methods, root resorption metrics, and follow-up periods, findings were synthesized narratively. In cone-beam computed tomography studies, plain corticotomy showed either small increases or no clear between-group differences in root resorption. Some graft-augmented corticotomy or osteotomy protocols were associated with slightly lower measured root resorption than conventional controls. In two-dimensional or index-based assessments, most comparisons showed no clear difference. Across studies, observed root resorption generally remained within commonly accepted clinical limits, but evidence certainty was low to very low.
conclusionsCurrent low- to very low-certainty evidence does not demonstrate a large increase in root resorption with invasive surgically accelerated orthodontics. However, the available studies are small, heterogeneous, and frequently at high risk of bias, preventing firm conclusions about safety. Findings suggesting slightly lower measured root resorption with some graft-augmented protocols remain hypothesis-generating and require confirmation in larger, better-designed studies with standardized outcomes and harms reporting.
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