Review Article

Year : 2026 | Volume : 17 | Issue : 1 | Page : 1-11

Dental Pulp Response and Tooth Discoloration after Orthognathic Procedures: A Systematic Review & Meta-Analysis

Haytham Jaha1 , Ibraheem K Bamaga2

1-Associate Professor and Consultant in Endodontics, Endodontic Division, Department of Restorative Dentistry, Faculty of Dental Medicine, 2-Associate Professor and Consultant in Orthodontics, Department of Basic and Clinical Oral Science, Faculty of Dental Medicine, Umm AI-Qura University, Makkah, Saudi Arabia

Address for Correspondence:

Dr. Haytham Jaha

Associate Professor and Consultant in Endodontics,

Endodontic Division, Department of Restorative Dentistry,

Faculty of Dental Medicine, Umm Al-Qura University,

Makkah, Saudi Arabia

Email: haythamjaha@gmail.com

ABSTRACT     

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.

Objective: This systematic review aims to evaluate the evidence regarding the dental pulp response and the incidence of discoloration following orthognathic procedures.

Materials & Methods: Relevant studies investigating pulp blood flow, pulp sensitivity, 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.

Results: Pulp blood flow in anterior teeth significantly drops immediately after surgery, often leading to negative pulp sensitivity tests in the first days and weeks post-operatively. Recovery of pulp sensitivity 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 sensitivity may indicate pulpal necrosis, warranting root canal therapy and non-vital bleaching as effective management. Patients should be informed of these potential complications preoperatively.

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.

Keywords:Orthognathic surgery; Dental pulp response; Pulp vitality; Pulp sensitivity: Pulp blood flow; Tooth discoloration; Le Fort I osteotomy; Genioplasty

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Haytham Jaha, Ibraheem K Bamaga. Dental Pulp Response and Tooth Discoloration after Orthognathic Procedures: A Systematic Review & Meta-analysis. Int J Orthod Rehabil 2026; 17 (1): 1-11.

Doi: 10.56501/Intjorthodrehabil.171.ijor0067