Effect of Orthodontic Tooth Movement on Sclerostin Expression in Alveolar Bone Matrix: A Systematic Review of Studies...

Background/Objectives: Sclerostin is a glycoprotein produced by osteocytes that regulates osseous remodeling, particularly in the context of orthodontic tooth movement. The purpose of the current systematic review is to assess the effect of orthodontic tooth movement (OTM) on sclerostin expression (SE) in the alveolar bone matrix (ABM). Methods: Indexed databases including PubMed, Embase and Web of Science were searched without time and language restrictions up to and including March 2025. Results: Seven studies performed on 8- to 12-week-old male rodents were included. The magnitude of orthodontic forces ranged from 10-120 g. Distalization and mesialization of the maxillary first molar were performed in one and six studies, respectively. In two studies, SE was increased on the compression and tension sides during OTM. In one study, SE is increased and decreased on the compression and tension sides, respectively; and another reported no difference in SE on the compression and tension sites during OTM. Two studies did not report data on SE on the control-sites (sites unexposed to OTM). Sample-size estimation was not performed in any of the included studies. All studies had a high risk of bias (RoB) and low certainty of evidence (CoE). Conclusions: Sclerostin may play a regulatory role in ABM during OTM. However, current evidence is limited by methodological inconsistencies, high RoB, and low CoE. Well-designed, power-adjusted studies using standardized protocols are required to establish reproducible findings and assess the translational potential of SE in orthodontics.