title: Influence of orthodontic forces on human dental pulp: a systematic review.
abstract: OBJECTIVE
  The aim of the present study was to systematically review the influence of orthodontic force on human dental pulp.
  
  
  RESULTS
  The addressed focused question was "Do orthodontic forces affect the human dental pulp?" which was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a specific question was constructed according to the PICO (Participants, Interventions, Control, Outcomes) principle. Databases were explored from 1952 up to and including August 2014 using different combinations of the following keywords: "orthodontic force"; "dental pulp"; "reaction" and "tooth movement". Literature reviews, letters to the editor, commentaries and case-reports were excluded. Thirty studies were included. Six studies assessed the effect of orthodontic forces on pulpal blood flow and 20 studies investigated the pulpal cellular responses to orthodontic forces. In 4 studies, pulpal responses to orthodontic forces were compared between previously traumatized- and non-traumatized teeth.
  
  
  CONCLUSIONS
  There is insufficient scientific validation regarding the association between orthodontic forces and human dental pulp. However, a history of dental trauma maybe considered a risk factor for loss of pulp vitality during orthodontic treatment.
authors.affiliation: Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
authors.forename: Fawad
authors.initials: F
authors.lastname: Javed
authors.affiliation: Research Chair for Dental Biomaterials, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11541, Saudi Arabia.
authors.forename: AbdulAziz A
authors.initials: AA
authors.lastname: Al-Kheraif
authors.affiliation: Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
authors.forename: Enisa B
authors.initials: EB
authors.lastname: Romanos
authors.affiliation: Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA. Electronic address: Georgios.Romanos@stonybrookmedicine.edu.
authors.forename: Georgios E
authors.initials: GE
authors.lastname: Romanos
mesh_terms: D003782:Dental Pulp / Q000098:blood supply; D006801:Humans; D012307:Risk Factors; D014087:Tooth Movement Techniques
keywords: Dental pulp; Growth factors; Orthodontic force; Pulpal blood flow