{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T14:25:47Z","timestamp":1774794347741,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,1,7]],"date-time":"2019-01-07T00:00:00Z","timestamp":1546819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Invest &amp; Clin Dent"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of the present study was to comprehensively review the influence of psychological stress exposure (<jats:styled-content style=\"fixed-case\">PSE<\/jats:styled-content>) on orthodontic therapy (<jats:styled-content style=\"fixed-case\">OT<\/jats:styled-content>). Original clinical and experimental studies were assessed. Quality assessment of experimental studies was performed using the Animal Research Reporting In Vivo Experiment (<jats:styled-content style=\"fixed-case\">ARRIVE<\/jats:styled-content>) guidelines. Six studies (2 clinical and 4 experimental) were included. One clinical study showed that <jats:styled-content style=\"fixed-case\">PSE<\/jats:styled-content> during <jats:styled-content style=\"fixed-case\">OT<\/jats:styled-content> significantly increases nickel release from orthodontic appliances into the saliva. In another study, maternal support was found to be an important predictor of the outcome of <jats:styled-content style=\"fixed-case\">OT<\/jats:styled-content>. In one experimental study, chronic <jats:styled-content style=\"fixed-case\">PSE<\/jats:styled-content> increased orthodontic tooth movement (<jats:styled-content style=\"fixed-case\">OTM<\/jats:styled-content>), and in two experimental studies, <jats:styled-content style=\"fixed-case\">PSE<\/jats:styled-content> decreased <jats:styled-content style=\"fixed-case\">OTM<\/jats:styled-content>. One study on rats reported that <jats:styled-content style=\"fixed-case\">PSE<\/jats:styled-content> is not a risk factor for orthodontically\u2010induced root resorption during <jats:styled-content style=\"fixed-case\">OTM<\/jats:styled-content>. One experimental study showed a significantly higher number of osteoclasts in the bone on the side of <jats:styled-content style=\"fixed-case\">OTM<\/jats:styled-content> in restrained rats compared with unrestrained rats. One study showed decreased osteoclast counts in the bone during <jats:styled-content style=\"fixed-case\">OTM<\/jats:styled-content> under <jats:styled-content style=\"fixed-case\">PSE<\/jats:styled-content>. The lowest, highest, and mean <jats:styled-content style=\"fixed-case\">ARRIVE<\/jats:styled-content> scores (out of 20) for the experimental studies were 16, 18, and 16.75\u00a0\u00b1\u00a00.96, respectively. The role of <jats:styled-content style=\"fixed-case\">PSE<\/jats:styled-content> in clinical orthodontics remains unclear, most likely due to a lack of studies in humans. Further power\u2010adjusted, well\u2010designed, and randomized studies are needed.<\/jats:p>","DOI":"10.1111\/jicd.12388","type":"journal-article","created":{"date-parts":[[2019,1,9]],"date-time":"2019-01-09T03:12:17Z","timestamp":1547003537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Influence of psychological stress exposure on orthodontic therapy: A comprehensive review"],"prefix":"10.1111","volume":"10","author":[{"given":"Deema","family":"Al\u2010Shammery","sequence":"first","affiliation":[{"name":"Department of Orthodontics Riyadh Elm University  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-4406","authenticated-orcid":false,"given":"Dimitrios","family":"Michelogiannakis","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopedics Eastman Institute for Oral Health University of 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