Reconsidering the Cellular Response to Orthodontic Tooth Movement. From Mechanical to Biochemical Perspectives

To determine minimal dose levels required for local inhibition of orthodontic relapse by recombinant OPG protein (OPG-Fc), while also determining effects of injected OPG-Fc on alveolar bone and long bone. The Department of Orthodontics and Pediatric Dentistry at the University of Michigan. Eighteen male Sprague Dawley rats. Maxillary molars were moved with nickel-titanium springs and then allowed to relapse in Sprague Dawley rats. Upon appliance removal, animals were injected with a single dose of 1.0 mg/kg OPG-Fc, 0.1 mg/kg OPG-Fc, or phosphate-buffered saline (vehicle) just distal to the molar teeth. Tooth movement measurements were made from stone casts, which were scanned and digitally measured. Alveolar tissues were examined by histology. Micro-computed tomography was used to quantify changes in alveolar and femur bone. Local injection of OPG-Fc inhibited molar but not incisor relapse, when compared to vehicle-injected animals. No significant differences in alveolar or femur bone were seen between the three treatment groups after 24 days of relapse. Our results demonstrate that a single local injection of OPG-Fc effectively inhibits orthodontic relapse, with minimal systemic bone metabolic effects. Our results also show that a single injection of OPG-Fc will influence tooth movement only in teeth close to the injection site. These findings indicate that OPG-Fc has potential as a safe and effective pharmacological means to locally control osteoclasts, for uses such as maintaining anchorage during orthodontic tooth movement and preventing orthodontic relapse in humans.

Orthodontic tooth movement is the result of bone remodeling that occurs in periodontal ligament and alveolar bone tissue as a response to mechanical loading of the tooth. The aim of this study is to investigate the time- and dose-response effects of locally administered clodronate on tooth movement. Sixty Wistar rats were randomly assigned to 4 groups of 15 specimens: E1 - application of 10 mMol of clodronate in 3-day intervals; E2 - application of 2.5 mMol of clodronate in 3-day intervals; E3 - application of 10 mMol of clodronate in 7-day intervals; E4 - application of 2.5 mMol of clodronate in 7-day intervals. A 50 μL clodronate solution was injected into a subperiosteal area to the right maxillary incisor. The left maxillary incisor served as a control, with an injection of saline solution. In 3-day interval application regime, there was no effect of clodronate dosing on tooth movement. In 7-day interval application regime, decreased tooth movement was observed with 10 mMol compared with 2.5 mMol clodronate concentration. However, decreased tooth movement was also observed when 2.5 mMol of clodronate was applied in 7-versus 3-day intervals. Conversely, no difference was observed when 10 mMol concentration was applied in 3- versus 7-day intervals. When clodronate is applied subperiosteally in the root area, it decreases the tooth movement. Tooth movement is impeded by the higher clodronate dosing, as well as by shorter application interval even with lower dosing. The purpose of future trials should, therefore, be to determine a safe therapeutic dose/interval application of clodronate in humans and their potential side effects.

Neural regulation of alveolar bone remodeling and periodontal ligament metabolism during orthodontic tooth movement in response to therapeutic loading

Residents' journal review

BackgroundOrthodontic tooth movement (OTM) relies on the remodeling of periodontal tissues, including the periodontal ligament (PDL) and alveolar bone. Collagen remodeling plays a crucial role during this process, allowing for the necessary changes in the PDL’s structure and function. Endo180, an urokinase plasminogen activator receptor-associated protein, is a transmembrane receptor regulated collagen remodeling. This study aims to investigate whether and how Endo180 participates in collagen remodeling within the PDL during OTM.Materials and methodsA mechanical force-induced OTM rat model was established using a closed coiled spring to mesially move the right maxillary first molar. The distance of OTM was examined by micro-computed tomography (micro-CT). The collagen remodeling within the PDL was assessed using atomic force microscope (AFM), Hematoxylin-Eosin (HE) staining and Masson staining. Protein expressions of Endo180, collagen I (COL I) and collagen III (COL III) were analyzed via immunofluorescence staining. Additionally, the mRNA expressions of Endo180, COL I, and COL III in force-induced PDL cells were examined by RT-qPCR in vitro. To further illustrate the role of Endo180 in regulating COL I and COL III expressions, Endo180 siRNA (siEndo) was applied to force-stimulated PDL cells.ResultsForce application increased OTM distance and disrupted collagen fiber organization, with a greater decrease in collagen elastic modulus on the mesial side than on the distal side of the PDL. After 7 days of force application, Endo180 and COL III expressions significantly increased in PDL tissues, while COL I expression decreased in PDL tissues. Compressive force loading in vitro upregulated the mRNA expressions of Endo180 and COL III, but downregulated COL I mRNA expression. Notably, Endo180 knockdown using siRNA suppressed force-induced COL III expression while restoring the downregulated COL I expression under compressive force stimuli.ConclusionForce-induced Endo180 expression modulates collagen remodeling in PDL during OTM by upregulating COL III and downregulating COL I. This collagen reorganization facilitates efficient tooth movement, highlighting Endo180 as a potential therapeutic target to optimize orthodontic treatment outcomes.

The sympathetic nervous system (SNS) regulates bone resorption through β-2 adrenergic receptor (Adrb2). In orthodontic tooth movement (OTM), mechanical force induces and regulates alveolar bone remodeling. Compressive force-associated osteoclast differentiation and alveolar bone resorption are the rate-limiting steps of tooth movement. However, whether mechanical force can activate Adrb2 and thus contribute to OTM remains unknown. In this study, orthodontic nickel-titanium springs were applied to the upper first molars of rats and Adrb1/2-/- mice to confirm the role of SNS and Adrb2 in OTM. The results showed that blockage of SNS activity in the jawbones of rats by means of superior cervical ganglion ectomy reduced OTM distance from 860 to 540 μm after 14 d of force application. In addition, the injection of nonselective Adrb2 agonist isoproterenol activated the downstream signaling of SNS to accelerate OTM from 300 to 540 μm after 7 d of force application. Adrb1/2-/- mice showed significantly reduced OTM distance (19.5 μm) compared with the wild-type mice (107.6 μm) after 7 d of force application. Histopathologic analysis showed that the number of Adrb2-positive cells increased in the compressive region of periodontal ligament after orthodontic force was applied on rats. Mechanistically, mechanical compressive force upregulated Adrb2 expression in primary-cultured human periodontal ligament cells (PDLCs) through the elevation of intracellular Ca2+ concentration. Activation of Adrb2 in PDLCs increased the RANKL/OPG ratio and promoted the peripheral blood mononuclear cell differentiation to osteoclasts in the cocultured system. Upregulation of Adrb2 in PDLCs promoted osteoclastogenesis, which accelerated OTM through Adrb2-enhanced bone resorption. In summary, this study suggests that mechanical force-induced Adrb2 activation in PDLCs contributes to SNS-regulated OTM.

Sustained mechanical forces applied to tissue are known to shape local immunity. In the oral mucosa, mechanical stress, either naturally induced by masticatory forces or externally via mechanical loading during orthodontic tooth movement (OTM), is translated, in part, by T cells to alveolar bone resorption. Nevertheless, despite being considered critical for OTM, depletion of CD4+ and CD8+ T cells is reported to have no impact on tooth movement, thus questioning the function of αβT cells in OTM-associated bone resorption. To further address the role of T cells in OTM, we first characterized the leukocytes residing in the periodontal ligament (PDL), the tissue of interest during OTM, and compared it to the neighboring gingiva. Unlike the gingiva, monocytes and neutrophils represent the major leukocytes of the PDL. These myeloid cells were also the main leukocytes in the PDL of germ-free mice, although at lower levels than SPF mice. T lymphocytes were more enriched in the gingiva than the PDL, yet in both tissues, the relative fraction of the γδT cells was higher than the αβ T cells. We thus sought to examine the role of γδT cells in OTM. γδT cells residing in the PDL were mainly Vγ6+ and produced interleukin (IL)–17A but not interferon-γ. Using Tcrd-GDL mice allowing conditional ablation of γδT cells in vivo, we demonstrate that OTM was greatly diminished in the absence of γδT cells. Further analysis revealed that ablation of γδT cells decreased early IL-17A expression, monocyte and neutrophil recruitment, and the expression of the osteoclastogenic molecule receptor activator of nuclear factor–κβ ligand. This, eventually, resulted in reduced numbers of osteoclasts in the pressure site during OTM. Collectively, our data suggest that γδT cells are essential in OTM for translating orthodontic mechanical forces to bone resorption, required for relocating the tooth in the alveolar bone.

Zoledronic acid (ZA) is often prescribed for osteoporosis or resorptive metabolic bone disease. This study aims to evaluate the effect of ZA on orthodontic tooth movement (OTM) and root and bone resorption and its repercussion on root, periodontal ligament and alveolar bone tissues. The experimental group consisted of 72 Wistar rats divided in four subgroups: Naive, Saline and Zoledronic Acid groups at the concentration of 0.2 mg/kg [ZA (0.2)] or 1.0 mg/kg [ZA (1.0)]. The animals were subjected to i.v (dorsal penile vein) administrations of ZA or saline solution, on days 0, 7, 14 and 42. Under anesthesia, NiTi springs were installed in the first left maxillary molar with 50gf allowing the OTM, except for the negative control group (N) for mesial movement of the left first maxillary teeth. The animals were sacrificed and maxillae were removed for macroscopic and histopathological analyzes, scanning electron microscopy, computerized microtomography and confocal microscopy. Treatment with ZA decreased the OTM and the number of osteoclasts and loss of alveolar bone when compared to the naive and saline groups. Reduction of radicular resorption, increased necrotic areas and reduced vascularization in the periodontal ligament were observed in the ZA groups. ZA interferes with OTM and presents anti-resorptive effects on bone and dental tissues associated with a decreased vascularization, without osteonecrosis.

Orthodontic tooth movement progresses by a combination of periodontal ligament (PDL) tissue and alveolar bone remodeling processes. Besides the remodeling of alveolar bone around the moving teeth, the major extracellular matrix (ECM) components of PDLs, collagens, are degenerated, degraded, and restructured. Matrix metalloproteinases (MMPs) and their specific inhibitors, tissue inhibitors of metalloproteinases (TIMPs), act in a co-ordinated fashion to regulate the remodeling of periodontal tissues. We hypothesized that the expression levels of the genes for MMP-2, MMP-9, and TIMPs 1-3 are increased transiently in the periodontal tissue during orthodontic tooth movement. To test this hypothesis, we employed an animal model of tooth movement using rats, as well as in situ hybridization to analyze the expression levels of Mmp-2, Mmp-9, and Timps 1-3. The expression levels of these genes increased transiently in cells of periodontal tissues, which include cementoblasts, fibroblasts, osteoblasts, and osteoclasts, at the compression side of the moving teeth. The transient increases in gene expression at the tension side were mainly limited to osteoblasts and cementoblasts. In conclusion, the expression levels of Mmp-2, Mmp-9, and Timps 1-3 increase transiently during orthodontic tooth movement at both the tension and compression sides. The expression of these genes is regulated differentially in the periodontal tissue of the tension side and compression side. This altered pattern of gene expression may determine the rate and extent of remodeling of the collagenous ECM in periodontal tissues during orthodontic tooth movement.

Acid and alkaline phosphatases were demonstrated histochemically in periodontal structures and alveolar bone tissues after experimental tooth movement. Previous reporting has concerned periodontal structures during orthodontic tooth movement (C. SANDSTEDT, Nord Tandl Tidsk No. 4,5, 1905; A.E. ZAKI and G.V. HUYSEN, JDent Res 42:1373-1379, 1963). Sixty Wistar strain rats were used in this experiment. During ether anesthesia, a rubber dam (1.5 mm wide and 0.15 mm thick) was inserted between the first and second molars on the left side of the upper jaw. The right side was observed as a control (K. TAKIMOTO ET AL: | Dent Res 45:1473-1476, 1966). Rats were killed in groups of 20 after one, three, and five days. In rats killed after five days, the rubber dam was replaced after three days by two rubber strips to exert a constant amount of force. Blocks of fresh tissue were prepared and decalcified for one week at 4C in a 10% solution of (tetrasodium salt of ethylendiamintetraacetate (EDTA), as a neutral solution adjusted to pH 7.0 with 5M citric acid. After rinsing in disstilled water, blocks were sagittally sectioned at 18,u in a cryostat with a sliding microtome. Serial sections were fixed (10% neutral formalin, 30 min) and stained with hematoxylin and eosin. The substrate solution for acid phosphatase consisted of 5 mg of naphthol AS-TR phosphate, dissolved in 0.1 ml of N-N dimethylformamide with 30 ml of 0.1M acetate buffer at pH 5.8 and added to 30 mg of fast red violet LB.* In sections incubated 1 to 1.5 hours at 37C, dark purple precipitation indicated enzyme-positive sites. The substrate solution for alkaline phosphatase consisted of 5 mg of naphthol AS-MX phosphate, dissolved in 0.1 ml of NCN dimethylformamide and 30 ml of Clark and Lub's buffer (K. KAWAKATSU and M. MORI, Cancer Res 23:539545, 1963) at pH 9.2 and added to 30 mg of fast red violet LB. After 30 to 50 minutes at 20C, enzyme-positive sites appeared red on a yellowbrown background. In normal tissues, moderate amounts of acid and alkaline phosphatases were observed in the periodontal ligaments. Alveolar bone surface and

Matrix metalloproteinases (MMPs) are zinc-dependent proteolytic enzymes involved in extracellular matrix remodelling in oral and dental tissues, including the periodontal ligament, alveolar bone, dentin, dental pulp, and periapical tissues. This narrative review summarises selected evidence on the role of MMPs and tissue inhibitors of metalloproteinases (TIMPs) in orthodontic tooth movement, dental trauma and root resorption, restorative adhesive dentistry, and pulp/periapical disease. Particular attention is given to signalling pathways that regulate MMP/TIMP activity, including nuclear factor kappa B (NF-κB), mitogen-activated protein kinase (MAPK), Wnt/β-catenin, and transforming growth factor beta (TGF-β)/Smad-related mechanisms. The review also discusses the biomarker potential and translational status of MMP-targeted strategies. Across clinical contexts, MMP activity contributes to both matrix degradation and tissue repair, and its biological effect depends on local stimuli, TIMP-mediated regulation, pathway crosstalk, and the stage of disease or treatment.

Hypercementosis has been previously reported in mice lacking progressive ankylosis protein (Ank KO mice, or Ank, KO - knockout, WT - wildtype) due to decreased levels of the mineralization inhibitor inorganic pyrophosphate. However, the impact of hypercementosis on alveolar bone remodeling and periodontal ligament (PDL) maintenance from orthodontic forces during orthodontic tooth movement (OTM) remains unclear. To investigate the roles of ANK protein on tooth movement, PDL maintenance, alveolar bone remodeling, and tooth root resorption, we performed a split-mouth model of OTM induced by a closed-coil spring stretched between the maxillary first molar and maxillary incisors in Ank KO and WT mice (including both males and females). Micro-computed tomographic analysis revealed a 36.6% reduction in OTM in Ank KO mice compared with WT mice, although OTM-induced thickening of PDL was found to be similar in both groups. While reduced tissue mineral density (TMD) of the alveolar bone was observed in WT mice, TMD in Ank KO mice was maintained. Loss of Ank leads to wider roots with thicker cementum on the untreated, contralateral side, whereas a significant increase in OTM-induced root resorption was observed on the lateral tension side. Histologic analysis of root resorption confirmed these data and showed increased resorption lacunae located prevalently in the OTM tooth root cementum of Ank KO mice. Using a quantitative PCR array of bone-associated markers to interrogate total RNA harvested from PDL tissues along the root surface, we found alterations in gene expression from OTM in both WT and Ank KO mice, which included genes involved in bone remodeling, calciotropic hormones and receptors, cytokines, growth factors, and receptors. Our findings advance the understanding of the role of Ank in regulating mineralization in the periodontium as well as factors involved in root resorption.

BackgroundOrthodontic tooth movement (OTM) is a complex biological process triggered by orthodontic forces (OF). This study aims to study the influence of sex and age on the gene expression of the dental pulp (DP) and periodontal ligament (PDL) of human premolars subjected to 7 and 28 days of OF in vivo.MethodologyLinear mixed and negative-binomial models were used on previously published RNA sequencing (RNA-seq) datasets of DP and PDL tissue subjected to OF for 7 days and 28 days to verify if the effect of OF depends on sex and age. Differentially expressed genes (DEGs) were identified using false discovery rate and functional analysis was performed.ResultsThe datasets consisted of 69 DP and 63 PDL samples from 46 and 41 patients respectively, with similar sex and age distribution. RNA-seq showed that sex did not influence the DP’s gene expression profile, since only one DEG related to immune response was detected after 28-days of OF. In contrast, sex significantly affected PDL: 505 DEGs were found after 7 days of OF, related to bone homeostasis, osteoclastic activity and immune response. Age impacted both tissues; in DP, 18 DEGs related to Ca2⁺ regulation and DNA damage repair were found at 7 days, and 10 DEGs associated with repair and adaptive capacities emerged at 28 days. In PDL, 181 genes related to bone regeneration were identified at 28 days, with no DEGs noted at 7 days.ConclusionOur study demonstrates that under OF, DP’s reaction is not sex-based, whereas PDL’s is, particularly in the early phase of OTM, with women showing a more pronounced osteoclastic response. Age-related effects in DP tissue primarily influence Ca2+ homeostasis and DNA damage repair in early phases, and tissue repair and adaptive responses later. In contrast, age impacts PDL tissue mainly in the later stages of OTM, affecting its regenerative capacity.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40510-025-00596-w.

The structural process of bone and periodontal ligament (PDL) remodeling during long-term orthodontic tooth movement (OTM) has not been satisfactorily described yet. Although the mechanism of bone changes in the directly affected alveolar bone has been deeply investigated, detailed knowledge about specific mechanism of PDL remodeling and its interaction with alveolar bone during OTM is missing. This work aims to provide an accurate and user-independent analysis of the alveolar bone and PDL remodeling following a prolonged OTM treatment in mice. Orthodontic forces were applied using a Ni–Ti coil-spring in a split-mouth mice model. After 5 weeks both sides of maxillae were scanned by high-resolution micro-CT. Following a precise tooth movement estimation, an extensive 3D analysis of the alveolar bone adjacent to the first molar were performed to estimate the morphological and compositional parameters. Additionally, changes of PDL were characterized by using a novel 3D model approach. Bone loss and thinning, higher connectivity as well as lower bone mineral density were found in both studied regions. Also, a non-uniformly widened PDL with increased thickness was observed. The extended and novel methodology in this study provides a comprehensive insight about the alveolar bone and PDL remodeling process after a long-duration OTM.

Toreview the role of the immune cells and their interaction with cells found in gingiva, periodontal ligament, and bone that leads to net bone loss in periodontitis or bone remodeling in orthodontic tooth movement. Periodontal disease is one of the most common oral diseases causing inflammation in the soft and hard tissues of the periodontium and is initiated by bacteria that induce a host response. Although the innate and adaptive immune response function cooperatively to prevent bacterial dissemination, they also play a major role in gingival inflammation and destruction of the connective tissue, periodontal ligament, and alveolar bone characteristic of periodontitis. The inflammatory response istriggered by bacteria or their products that bind to pattern recognition receptors that induce transcription factoractivityto stimulatecytokine and chemokineexpression. Epithelial, fibroblast/stromal, and resident leukocytes play a key role in initiating the host response and contribute to periodontal disease. Single-cell RNA-seq (scRNA-seq) experiments have added new insight into the roles of various cell types in the response to bacterial challenge. This response is modified by systemic conditions such as diabetes and smoking. In contrast to periodontitis, orthodontic tooth movement (OTM) is a sterile inflammatory response induced by mechanical force. Orthodontic force application stimulates acute inflammatory responses in the periodontal ligament and alveolar bone stimulated by cytokines and chemokines that produce bone resorption on the compression side. On the tension side, orthodontic forces induce the production of osteogenic factors, stimulating new bone formation. A number ofdifferent celltypes, cytokines, and signaling/pathways are involved in this complex process. Inflammatory and mechanical force-induced bone remodeling involves bone resorption and bone formation. The interaction of leukocytes with host stromal cells and osteoblastic cells plays a key role in both initiating the inflammatory events as well as inducing a cellular cascade that results in remodeling in orthodontic tooth movement or in tissue destruction in periodontitis.