Biological Interplay between Orthodontic Forces and Apical Papilla-Derived Stem Cells: A review on Mechanisms and Implications

Abstract

Introduction: Orthodontics is not limited to the movement of teeth, but has also expanded to the cellular and molecular realms. In this study, it was aimed to review mechanisms and implications of biological interplay between orthodontic forces and apical papilla-derived stem cells.
Methods: This narrative and semi-systematic review investigates the biological interactions between orthodontic forces and stem cells derived from the apical papilla (SCAPs). A comprehensive literature search was conducted in PubMed, Web of Science, and Google Scholar using specific keywords and MeSH terms from 2015 to 2025. Studies in English and Persian were included if they focused on the effects of orthodontic forces on SCAPs’ function, differentiation, or signaling pathways. In vitro, in vivo, and clinical studies were reviewed. Screening was independently performed by two reviewers, with disagreements resolved by a third. Key biological mechanisms and molecular responses were extracted and analyzed.
Results: 539 records were identified, and after screening, 12 studies were included. These studies, conducted mainly in China, Iran, USA, India, Thailand, and Russia, explored the effects of physical, chemical, and microbial factors on dental stem cells. Eight studies focused on SCAPs using in vitro models. Most used gene and protein expression analyses, with limited demographic data and a focus on young populations.
Conclusion: Current evidence shows that various physical, chemical, microbial, and molecular factors influence dental stem cell behavior. Understanding these mechanisms can support the development of personalized therapies, enhancing outcomes in endodontic and orthodontic treatments—particularly under pathological conditions like diabetes and chronic inflammation.