Does the rate of orthodontic tooth movement change during pregnancy and lactation? A systematic review of the evidence from animal studies.
BACKGROUND
The changes in bone homeostasis observed during pregnancy and lactation could result in alterations in the rate of orthodontic tooth movement, but research in human subjects presents significant ethical and practical limitations. Our aim was to compare the amount of orthodontic tooth movement between pregnant/lactating or not animals.


METHODS
We searched without restrictions 8 databases and performed hand searching until July 2019 (PubMed, Central, Cochrane Database of Systematic Reviews, SCOPUS, Web of Science, Arab World Research Source, ClinicalTrials.gov , ProQuest Dissertations and Theses Global). We searched for studies comparing quantitatively the amount of orthodontic tooth movement between pregnant/lactating or not animals. Following retrieval and selection of studies, the collection of related data was performed and the risk of bias was assessed using the SYRCLE's Risk of Bias Tool. Exploratory synthesis was carried out using the random effects model.


RESULTS
Four studies were finally identified raising no specific concerns regarding bias. One study showed that lactation increased the rate of tooth movement by 50 % [p < 0.05]. Although an overall increase was noted in the pregnancy group as well, it did not reach statistical significance [3 studies, Weighted Mean Difference: 0.10; 95% Confidence Interval: - 0.04 - 0.24; p = 0.165].


CONCLUSIONS
The metabolic changes occurring during pregnancy and lactation may have an impact on the rate of tooth movement in animals. Although these animal experimental results should be approached cautiously, it could be safe practice to consider the impact of these physiological changes in the clinical setting.


REGISTRATION
PROSPERO (CRD42018118003).
['Omar|Moaza|M|', 'Kaklamanos|Eleftherios G|EG|0000-0002-0513-5110']
D000818:Animals D005260:Female D006801:Humans D007774:Lactation D011247:Pregnancy D014087:Tooth Movement Techniques
Pregnancy Lactation Rate of tooth movement Orthodontic treatment