Abstract

Orthodontic tooth movement to therapeutically align malpositioned teeth is supposed to impact blood flow in the surrounding tissues. Here, we evaluated actual vascularization in the tension area of the periodontal ligament during experimental tooth movement in rats (N = 8) with magnetic resonance imaging (MRI). We inserted an elastic band between the left upper first and the second rat molar; the right side was not treated and served as control. After four days of tooth movement, we recorded T1-weighted morphologic and dynamic-contrast-enhanced MRI sequences with an animal-specific 7 Tesla MRI to assess of local vascularization. Furthermore, we quantified osteoclasts and monocytes in the periodontal ligament, which are crucial for orthodontic tooth movement, root resorptions as undesirable side effects, as well as the extent of tooth movement using paraffine histology and micro-CT analysis. Data were tested for normal distribution with Shapiro–Wilk tests followed by either a two-tailed paired t-test or a Wilcoxon matched-pairs signed rank test. Significant orthodontic tooth movement was induced within the four days of treatment, as evidenced by increased osteoclast and monocyte activity in the periodontal ligament as well as by µCT analysis. Contrast enhancement was increased at the orthodontically-treated side distally of the moved upper first left molar, indicating increased vascularization at the tension side of the periodontal ligament. Accordingly, we detected reduced time-to-peak and washout rates. Our study using MRI to directly assess local vascularization thus seems to confirm the hypothesis that perfusion is enhanced in tension zones of the periodontal ligament during orthodontic tooth movement.

Highlights

  • According to the pressure–tension theory of orthodontic tooth movement, treatment with fixed or removable orthodontic appliances results in the development of compressed and stretched areas within the periodontal tissue with alveolar bone resorption at compression and alveolar bone formation at tension areas [1,2,3], which could last up to 6 months into the retention phase [4]

  • This results in elevated expression levels of receptor activator of nuclear factor kappa b ligand (RANKL) upon compressive force treatment in periodontal ligament fibroblasts [6,8,9]

  • Eight male Fischer 344 rats (Rattus norvegicus Berkenhout, Charles River Laboraties, Sulzfeld, Germany) aged 7 weeks were included in this study, which was approved by the responsible authorities and performed in compliance with the German Animal Protection Act

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Summary

Introduction

According to the pressure–tension theory of orthodontic tooth movement, treatment with fixed or removable orthodontic appliances results in the development of compressed and stretched areas within the periodontal tissue with alveolar bone resorption at compression and alveolar bone formation at tension areas [1,2,3], which could last up to 6 months into the retention phase [4]. These mechanical stimuli are recognized by several cell types in the tooth surrounding tissues, including periodontal. The RANKL/OPG system is strongly involved in a cross-regulation of the bone and immune system [11]

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