How does orthodontic tooth movement impact endodontic treatment and the outcome?
Teeth undergoing orthodontic tooth movement may require endodontic treatment which could be related or unrelated to orthodontic treatment.
However, it is always preferable to try to foresee and treat the tooth endodontically prior to beginning orthodontics for some of the following reasons:
- Pulpal or periradicular pain can be masked by discomfort associated with that of tooth movement.
- Once fixed appliances are placed on teeth, rubber dam isolation can be difficult.
- Creating endodontic access preparations can be confusing as the long axis of the tooth may be difficult to determine.
- Working lengths or finding apical stops may be compromised by root resorption at the apex.
- Apical root resorption will also complicate obturation of the tooth.
- The response of pulp tissues to pulp stimuli may also be altered by orthodontic tooth movement.
Source: Endodontics, 4th Edition, Elsevier 2014.