Dental Pulp Response and Discoloration after Orthognathic Procedures: A Systematic Review & Meta analysis

<p> </p><p> </p><p>Background: Orthognathic surgery, including procedures such as Le Fort I osteotomy and genioplasty, is performed to correct craniofacial discrepancies and malocclusions. However, these procedures may lead to complications such as changes in dental pulp response and tooth discoloration.</p><p> </p><p>Objective: This systematic review aims to evaluate the evidence regarding the dental pulp response and the incidence of discoloration following orthognathic procedures.</p><p> </p><p>Methods: Relevant studies investigating pulp blood flow, pulp sensibility, and dental discoloration after orthognathic surgery were reviewed. Observational studies, case reports, and clinical investigations on pulp response and discoloration in patients undergoing procedures such as Le Fort I osteotomy were included.</p><p> </p><p>Results: Pulp blood flow in anterior teeth significantly drops immediately after surgery, often leading to negative pulp sensibility tests in the first days and weeks post-operatively. Recovery of pulp sensibility occurs gradually, with some teeth regaining a positive response within three months. Dental discoloration occurs in approximately 3.5-5% of cases after orthognathic procedures, mainly due to vascular impairment or mechanical injury to the apical region. Discoloration may present early, sometimes as a dark pink hue, and is often reversible; however, persistent discoloration combined with loss of pulp sensibility may indicate pulpal necrosis, warranting root canal therapy and non-vital bleaching as effective management. Patients should be informed of these potential complications preoperatively.</p><p> </p><p>Conclusion: Orthognathic surgery can acutely affect pulp vitality and pose a risk of dental discoloration via vascular or mechanical trauma. Most cases resolve with conservative dental management. Awareness and monitoring are critical for early identification and appropriate treatment to ensure satisfactory esthetic and functional outcomes.</p><p> </p>