Orthognathic surgery-induced bone remodeling and the acceleration of orthodontic tooth movement: a scoping review.

Abstract

Background: Accelerated tooth movement after orthognathic surgery has been observed in clinical settings and referenced in the literature.

Objective: To map the existing literature on whether orthodontic tooth movement is accelerated by reactive bone remodeling after orthognathic surgery.

Search methods: A scoping literature review of human and animal studies was conducted. Unrestricted searches in six electronic databases and gray literature sources were performed and updated in January 2025. A manual search of the reference list was also undertaken.

Selection criteria: We searched for primary studies assessing the rate of tooth movement (primary outcome) or change in bone remodeling or bone density (secondary outcomes) in patients who underwent orthognathic surgery or in animals subjected to major jaw osteotomy.

Data collection and analysis: Two independent reviewers selected studies and extracted data, with a third reviewer consulted if needed.

Results: Out of 8296 identified records, eight studies published between 2008 and 2021 were included. In the animal model (n = 4), significant individual variation was noted in the rate of tooth movement following osteotomies. In humans (n = 4), metabolic changes in bone markers and a decreased alveolar bone density were recognized.

Limitations: The results of the present scoping review are based mainly on human secondary outcomes.

Conclusions and implications: Increased cellular and molecular activity following orthognathic surgery or major jaw osteotomy has been demonstrated in human and animal models. This biological response is associated with the systemic acceleratory phenomenon and regional acceleratory phenomenon triggered by the extent of surgical trauma. At the local level, these changes involve enhanced bone remodeling activity accompanied by a transient reduction in bone mineral density. Most available evidence in humans suggests that these effects are temporary, typically peaking within the first month post-surgery and diminishing within three months. However, definitive evidence supporting a clinically significant acceleration of orthodontic tooth movement in humans remains limited, with current understanding primarily based on robust animal studies. While the primary outcome could not be demonstrated in humans and warrants further investigation, the potential for optimizing the efficiency of post-surgical orthodontic treatment should not be overlooked.

Registration: Open Science Framework (10.17605/OSF.IO/CWGA3).

Funding: The present study has not received any contributions from private or public funding agencies. The National Council for Scientific and Technological Development (CNPq) supports Professor Graziela De Luca Canto.