Analysis Of Orthodontic Tooth Movement Research Articles

Evaluating the long-term stability of a predefined palatal region for tooth movement analysis

ObjectivesWe conducted a three-dimensional (3D) analysis of orthodontic tooth movement (TM) using digital dental models (DMs), focusing on the palatal region of interest (PROI), aiming to evaluate the long-term stability of the PROI, validate the 3D TM analysis with PROI registration, and compare it with conventional lateral cephalometric analyses. MethodsTwenty adult patients treated with a multibracket appliance were evaluated at their first visit (T0) and at least 5 years later (T1) using DMs and lateral cephalograms (LCs). The long-term stability of PROI was assessed by calculating the point cloud distances between DM-T0 and DM-T1. TM analysis using DM with PROI registration for the maxillary central incisors was assessed through linear and angular measurements in the sagittal view and subsequently compared with the LCs. ResultsThe average point cloud distance of the PROI between DM-T0 and DM-T1 was 0.21 mm (standard deviation, 0.13 mm). TM analysis using DMs demonstrated excellent reproducibility for both linear and angular measurements (intra-rater correlation coefficient, > 0.99). The 95 % limits of agreement between the DM and LC measurements were < 5.14° for angular change, 3.53 mm for horizontal displacement, and 0.98 mm for vertical displacement. No significant differences were observed in the angular and linear measurements when the TM was compared using the DMs and LCs. ConclusionsThe PROI remained stable for over 5 years, supporting the reproducibility and accuracy of TM assessment using PROI registration in orthodontic clinical practice. Clinical significanceDM analysis lacks the risks associated with X-ray exposure and can be easily performed in daily clinical practice, indicating its potential for future clinical applications. These findings further support the use of DM with PROI registration for TM analysis in orthodontic clinical practice, emphasizing its long-term stability and reproducibility.

MicroRNA-21 Contributes to Orthodontic Tooth Movement

microRNAs could be mechanosensitive and emerge as critical posttranscriptional regulators in the bone-remodeling process. During orthodontic tooth movement (OTM), the application of mechanical force induces alveolar bone remodeling, but whether microRNAs respond to orthodontic force and contribute to OTM is unknown. microRNA-21 (miR-21) has been previously reported in vitro to mediate stretch-induced osteogenic differentiation of periodontal ligament stem cells and support osteoclast differentiation. In this study, the authors show that miR-21 responded to orthodontic force in periodontal tissue in a dose- and time-dependent manner and regulated the osteogenesis of human periodontal ligament stem cells following OTM. Using mmu-miR-21-deficient (miR-21-/-) mice, the authors discovered that mmu-miR-21 deficiency inhibited OTM and prevented force-induced maxillary bone loss. The authors found that miR-21-/- mice showed a normal skeletal phenotype in development and a similar alveolar bone formation rate to wild-type mice postnatally. During OTM, mmu-miR-21 regulated force-induced alveolar osteoblastogenesis in the tensile side, while no effects were detected in the compressive side. However, miR-21-/- mice showed inhibited alveolar osteoclastogenesis when compared with wild-type mice. During OTM, mmu-miR-21 deficiency blocked alveolar bone resorption in both the compressive and tensile sides. To dissect the mechanism by which miR-21 regulates alveolar bone remodeling, the authors screened the reported functional targets of miR-21 and found that periodontal expression of programmed cell death 4 (Pdcd4) was inhibited following OTM. Furthermore, mmu-miR-21 deficiency removed the suppression of Pdcd4 at both the mRNA and protein levels in the periodontium, resulting in upregulation of the downstream effector C-fos. Further analysis of OTM under lipopolysaccharide-induced periodontal inflammation showed that mmu-miR-21 mediated lipopolysaccharide (LPS)-accelerated OTM and that mmu-miR-21 deficiency blocked lipopolysaccharide-induced maxillary bone loss. In summary, these findings reveal a previously unrecognized mechanism that a microRNA can modulate OTM and alveolar bone remodeling under both normal and inflammatory microenvironments in vivo.

Effect of material variation on the biomechanical behaviour of orthodontic fixed appliances: a finite element analysis.

Biomechanical analysis of orthodontic tooth movement is complex, as many different tissues and appliance components are involved. The aim of this finite element study was to assess the relative effect of material alteration of the various components of the orthodontic appliance on the biomechanical behaviour of tooth movement. A three-dimensional finite element solid model was constructed. The model consisted of a canine, a first, and a second premolar, including the surrounding tooth-supporting structures and fixed appliances. The materials of the orthodontic appliances were alternated between: (1) composite resin or resin-modified glass ionomer cement for the adhesive, (2) steel, titanium, ceramic, or plastic for the bracket, and (3) β-titanium or steel for the wire. After vertical activation of the first premolar by 0.5mm in occlusal direction, stress and strain calculations were performed at the periodontal ligament and the orthodontic appliance. The finite element analysis indicated that strains developed at the periodontal ligament were mainly influenced by the orthodontic wire (up to +63 per cent), followed by the bracket (up to +44 per cent) and the adhesive (up to +4 per cent). As far as developed stresses at the orthodontic appliance are concerned, wire material had the greatest influence (up to +155 per cent), followed by bracket material (up to +148 per cent) and adhesive material (up to +8 per cent). The results of this in silico study need to be validated by in vivo studies before they can be extrapolated to clinical practice. According to the results of this finite element study, all components of the orthodontic fixed appliance, including wire, bracket, and adhesive, seem to influence, to some extent, the biomechanics of tooth movement.

Differentiated analysis of orthodontic tooth movement in rats with an improved rat model and three-dimensional imaging

Rat models currently available for analysis of orthodontic tooth movement often lack differentiated, reliable and precise measurement systems allowing researchers to separately investigate the individual contribution of tooth tipping, body translation and root torque to overall displacement. Many previously proposed models have serious limitations such as the rather inaccurate analysis of the effects of orthodontic forces on rat incisors. We therefore developed a differentiated measurement system that was used within a rat model with the aim of overcoming the limitations of previous studies. The first left upper molar and the upper incisors of 24 male Wistar rats were subjected to a constant orthodontic force of 0.25 N by means of a NiTi closed coil spring for up to four weeks. The extent of the various types of tooth movement was measured optometrically with a CCD microscope camera and cephalometrically by means of cone beam computed tomography (CBCT). Both types of measurement proved to be reliable for consecutive measurements and the significant tooth movement induced had no harmful effects on the animals. Movement kinetics corresponded to known physiological processes and tipping and body movement equally contributed to the tooth displacement. The upper incisors of the rats were significantly deformed and their natural eruption was effectively halted. The results showed that our proposed measurement systems used within a rat model resolved most of the inadequacies of previous studies. They are reliable, precise and physiological tools for the differentiated analysis of orthodontic tooth movement while simultaneously preserving animal welfare.

Three-dimensional analysis of orthodontic tooth movement based on XYZ and finite helical axis systems

The purpose of this study was to demonstrate the advantage of the finite helical axis (FHA) system in the biomechanical analysis of orthodontic tooth movement by comparing it with the rectangular coordinate (XYZ) system. Ten patients (6 females and 4 males, mean age 23 years 7 months) were selected. Maxillary canine retraction using light continuous forces of two different magnitudes (0.5 and 1 N) was used to retract the right and left maxillary canines in subjects who required maximum posterior anchorage. The findings were compared based on midpalatal implants that provided a fixed reference for measurement. The significance of the difference between the results with the two different force magnitudes was determined using Wilcoxon's signed-rank test. With both the XYZ and the FHA system, no significant differences in the amount of distal movement of the canines over 2 months were found between the two force magnitudes. However, the results showed that the canine was likely to incline distally during tooth retraction with a force of 1 N compared with a force of 0.5 N (P < 0.05). With the FHA system, the result indicated that the canine was likely to incline palatally during tooth retraction with a force of 0.5 N compared with a force of 1 N (P < 0.05). In this study, the combination of these two different approaches for describing tooth movement clearly showed a difference between light continuous forces of 0.5 and 1 N.

Basic behavior of the finite helical axis in a simple tooth movement simulation

A finite helical axis (FHA) analysis can provide precise three-dimensional information on orthodontic tooth movement compared to an analysis based on a rectangular coordinate system. The FHA has already been applied in an analysis of orthodontic tooth movement. Interestingly, the position of the FHA changes dramatically in different stages of treatment; however, no previous report has provided detailed information of its basic behavior for clinicians. The purpose of this study was to clarify the basic behavior of the FHA in simple tooth movement, which could promote a better understanding of the 3-D orientation of and rotation about the FHA during tooth movement. Parameters of the FHA were calculated from a simulation of canine retraction. As the tipping angle of the canine was increased from 5° to 30°, the orientation vector of the FHA approached the most affected axis of rotation (on a rectangular coordinate system) in a non-linear manner. The angle of rotation about the FHA also increased in a non-linear manner. This non-linear problem was solved analytically. The basic behavior of the orientation vector of the FHA and the non-linear characteristics of the FHA parameters clarified in this study should be important for the future analysis of actual tooth movement based on the FHA. However, we must be aware that the non-linearity of the FHA itself may affect the analysis of the mechanical properties of the periodontal tissue.

The influence of PDL principal fibers in a 3-dimensional analysis of orthodontic tooth movement.

The effects of mechanical loads on the tooth-alveolus complex are of particular concern in orthodontics. The concepts of center of resistance (CRes) and center of rotation (CRot) are used to characterize tooth responses to orthodontic loads. The mechanical environment (stresses and strains) associated with orthodontic tooth movement is a unique model in bone adaptation physiology. Numerous finite element models of varying complexity have been developed to calculate tooth movements and stress distributions within the alveolar bone and the periodontal ligament (PDL). In general, the PDL has been idealized as a homogeneous isotropic material. For this project, a 3-dimensional tooth/PDL/mandible/finite element model was developed in which, for the first time in such an analysis, the PDL's principal-fiber structure was also incorporated. Parametric analyses showed that the fiber orientation and the mechanical properties do not exert much influence on the locations of the CRes and the CRot and on the stress patterns within the bone and the PDL matrix. However, the absence of principal fibers produces not only different stress magnitudes, but also differences in stress patterns. Furthermore, the no-fiber-associated CRes and CRot are considerably separated from the cluster of fiber-influenced centers. It was concluded that it may be more realistic to incorporate "generic" principal fibers into finite element models than not to include them at all, despite the lack of reliable information about fibers.

Three-dimensional analysis of orthodontic tooth movement

A three-dimensional finite element model was used to investigate the biomechanical response of an upper canine tooth. The physical model was developed from ceramic replicas and X-rays, and consisted of cancellous and cortical bone, the periodontal ligament, dentine and pulp chamber. Horizontal forces were applied at the tip of the crown and at the cervical margin and a rotational force was applied at the cervical margin of the tooth crown. The resulting displacements and stress field for each load case are presented with particular emphasis being placed on the response of the periodontal ligament. The investigation shows that quantitative information on initial tooth movement can be accurately predicted and used to evaluate the response of orthodontic treatment.