Effect Of Orthodontic Force Research Articles

Using Inducible Osteoblastic Lineage-Specific Stat3 Knockout Mice to Study Alveolar Bone Remodeling During Orthodontic Tooth Movement.

The alveolar bone, with a high turnover rate, is the most actively-remodeling bone in the body. Orthodontic tooth movement (OTM) is a common artificial process of alveolar bone remodeling in response to mechanical force, but the underlying mechanism remains elusive. Previous studies have been unable to reveal the precise mechanism of bone remodeling in any time and space due to animal model-related restrictions. The signal transducer and activator of transcription 3 (STAT3) is important in bone metabolism, but its role in osteoblasts during OTM is unclear. To provide in vivo evidence that STAT3 participates in OTM at specific time points and in particular cells during OTM, we generated a tamoxifen-inducible osteoblast lineage-specific Stat3 knockout mouse model, applied orthodontic force, and analyzed the alveolar bone phenotype. Micro-computed tomography (Micro-CT) and stereo microscopy were used to access OTM distance. Histological analysis selected the area located within three roots of the first molar (M1) in the cross-section of the maxillary bone as the region of interest (ROI) to evaluate the metabolic activity of osteoblasts and osteoclasts, indicating the effect of orthodontic force on alveolar bone. In short, we provide a protocol for using inducible osteoblast lineage-specific Stat3 knockout mice to study bone remodeling under orthodontic force and describe methods for analyzing alveolar bone remodeling during OTM, thus shedding new light on skeletal mechanical biology.

Endodontic Considerations in Contemporary Orthodontic Practice- A Review

Introduction: With increase in number of adult orthodontic patients, the orthodontic- endodontic related patients are also expected to rise. There are number of clinical dilemma where both the specialties need robust guideline for clinical decision making. The effect of orthodontic force is expressed in different way in different patients and teeth which need to be understood by clinicians. On the contrary, the tooth movement of endodontically involved teeth demands careful evaluation of the tooth and its surrounding tissue, quality of root treatment, presence or absence of peri-apical pathologies, previous history of trauma etc. Management of external apical root resorption following orthodontic therapy might be challenging some time. Orthodontic extrusion of fractured teeth is one of the viable prosthetic rehabilitation options where orthodontic, endodontic and prosthodontics specialties are involved. So this review article will focus on reviewing current level of evidence on orthodontic- endodontic interface.

Effect of the Maxillary Sinus on Tooth Movement during Orthodontics Based on Biomechanical Responses of Periodontal Ligaments

The maxillary sinus is a common anatomic limitation for orthodontic tooth movement. The effect of orthodontic forces on a particular anatomy can be studied using finite element analysis (FEA). Our study aimed to determine the effect of different tooth penetration depths into the maxillary sinus floor (MSF) on the orthodontic force system for bodily tooth movement. Using the cone-beam computed tomography of a patient with low MSF, we modeled the geometry of canine, premolar, and molar teeth with their periodontal ligaments and the alveolar bone surrounding them. The models were manually modified to simulate different root penetration depths. Thereafter, the center of resistance and stress distributions for teeth penetrating into the MS were determined using FEA. Moreover, the force systems for teeth with a low MSF to varying degree were evaluated based on the FEA results. During orthodontic tooth movement, the individual differences in the periodontal anatomy should be considered. The CR position decreases with the penetration depth, while the average hydrostatic stress in the PDL increases rapidly. In this paper, we present the correction coefficients of the orthodontic force and moment for a tooth penetrating into the MSF, which is necessary for personalized treatment planning.

The effect of orthodontic forces on calcitonin gene-related peptide (CGRP) expression in the human periodontal ligament and its relationship with the human dental pulp.

The purpose of this study was to quantify the effect of moderate and severe orthodontic forces on Calcitonin gene-related peptide (CGRP) expression in the healthy human periodontal ligament (PDL) and its possible relationship with the human dental pulp. Ninety human periodontal ligament samples were obtained from healthy premolars where extraction was indicated for orthodontic reasons. Prior to extraction, teeth were divided in 3 groups of 30 samples each: I) Untreated teeth control group; II) Moderate force group: A 56 g force was applied to the premolars for 24 hours; and III) Severe force group: A 224 g force was applied to the premolars for 7 days. All periodontal ligament samples were processed and CGRP was measured by radioimmunoassay. Greater CGRP expression was found in the severe force group, followed by the moderate force group. The lower CGRP values were for the untreated teeth. Kruskal-Wallis test showed statistically significant differences between groups (p<0.001). LSD post hoc tests showed statistically significant differences in CGRP expression between the untreated teeth and the severe forces group (p<0.001). Differences between the moderate and severe force groups were statistically significant (p<0.001). There was no statistically significant differences between the untreated teeth and the moderate forces group (p<0.261). CGRP expression in human periodontal ligament increases when teeth are submitted to severe orthodontic forces. This elevated expression of CGRP, which is proportional to the applied force, may affect the way the dental pulp responds to different stimuli from the orthodontic forces. Key words:Calcitonin gene-related peptide, orthodontic force, human periodontal ligament, neurogenic inflammation.

Finite Element Analysis of Mandibular Anterior Teeth with Healthy, but Reduced Periodontium

Finite element analysis studies have been of interest in the field of orthodontics and this is due to the ability to study the stress in the bone, periodontal ligament (PDL), teeth and the displacement in the bone by using this method. Our study aimed to present a method that determines the effect of applying orthodontic forces in bodily direction on a healthy and reduced periodontium and to demonstrate the utility of finite element analysis. Using the cone-beam computed tomography (CBCT) of a patient with a healthy and reduced periodontium, we modeled the geometric construction of the contour of the elements necessary for the study. Afterwards, we applied a force of 1 N and a force of 0.8 N in order to achieve bodily movement and to analyze the stress in the bone, in the periodontal ligament and the absolute displacement. The analysis of the applied forces showed that a minimal ligament thickness is correlated with the highest value of the maximum stress in the PDL and a decreased displacement. This confirms the results obtained in previous clinical practice, confirming the validity of the simulation. During orthodontic tooth movement, the morphology of the teeth and of the periodontium should be taken into account. The effect of orthodontic forces on a particular anatomy could be studied using FEA, a method that provides real data. This is necessary for proper treatment planning and its particularization depends on the patient’s particular situation.

Effects of orthodontic forces on bone turnover biomarkers in peri-miniscrew crevicular fluid: A systematic review

Peri-miniscrew crevicular fluid (PMCF) analysis of biomarkers representing bone formation or resorption could provide a non-invasive way to monitor bone turnover around miniscrews and the response to force loading. Our objective was to systematically investigate the relevant available evidence. Search without restrictions in eight databases and hand searching until March 2020 took place. We searched for prospective human studies measuring the levels of markers of bone formation and resorption in PMCF under the effect of orthodontic forces. Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed following the Cochrane Collaboration guidelines. Four studies, two randomized and two non-randomized, were finally identified, following miniscrews for a period up to 90 days. Loading of miniscrews led to a transient increase in C-telopeptide of type I collagen amounts. Temporary increases were also observed for the enzymes: alkaline phosphatase and aspartate aminotransferase. Under the effect of orthodontic loading the total amount of Receptor Activator of Nuclear Factor-κB Ligand (RANKL) in the PMCF consistently increased compared to the unloaded group, at all sampling points. These changes led to a stable decrease in the osteoprotegerin (OPG)/RANKL ratio under force application throughout the study period, as OPG in this group, together with OPG and RANKL in the unloaded group, remained mostly unchanged. No differences were detected for the total OPG quantity between the two loading groups. The levels of bone specific alkaline phosphatase and chondroitin sulfate did not change significantly during observation. All studies presented some issues of concern regarding the risk of bias. Biomarkers of bone turnover in PMCF showed variable responses following orthodontic loading. Overall, the findings were suggestive of adaptive bone alterations to physiologic force stimuli.

Effect of Orthodontic Force on Salivary Levels of Lactate Dehydrogenase Enzyme

Orthodontic tooth movement is characterized by tissue reactions, which consist of an inflammatory response in periodontal ligament and followed by bone remodeling in the periodontium depending on the forces applied. These processes trigger the secretion of various proteins and enzymes into the saliva. The purpose of this study was to evaluate the activity of the lactate dehydrogenase (LDH) in saliva during orthodontic tooth movement using different magnitude of continuous orthodontic forces.

Effects of orthodontic force on root surface damage caused by contact with temporary anchorage devices and on the repair process.

ObjectiveThis study aimed to evaluate the effects of force loading on root damage caused by contact with temporary anchorage devices (TADs) during orthodontic treatment and to examine the repair process 4, 8, and 12 weeks after TAD contact by micro-computed tomography (CT).MethodsWe enrolled 42 volunteers who required bilateral upper first premolar extractions. The experimental study design was as follows. For both first premolars, cantilever springs were placed, and then TADs were immediately inserted between the premolars of all volunteers. According to the removal order of the appliances, the participants were divided into the TAD group (Group T: n = 21, only TAD removal) and the spring group (Group S: n = 21, only spring removal). A split-mouth design was adopted in both groups as follows. For each volunteer, the left premolars were extracted 4, 8, or 12 weeks after TAD-root contact. The right premolars were extracted immediately after contact in both groups (Groups T-C and S-C) and used as positive controls. Resorption volumes and numbers of craters were determined by micro-CT.ResultsThe numbers of resorption craters were higher in Group T than in Group S at 8 and 12 weeks (p < 0.01). Crater volumes were higher in Group T than in Group S at 4 and 12 weeks (p < 0.01, both).ConclusionsRoot injury was not completely repaired 12 weeks after root-TAD contact, even when the TADs were removed in cases of continuous force application.

Effect of orthodontic forces on levels of enzymes in gingival crevicular fluid (GCF): A systematic review.

Objective: Orthodontic force application releases multiple enzymes in gingival crevicular fluid (GCF) for activation, resorption, reversal, deposition of osseous elements and extracellular matrix degradation. The current systematic review critically evaluated all existing evidence on enzymes in orthodontic tooth movement. Methods: Literature was searched with predetermined search strategy on electronic databases (PubMed, Scopus, Embase), along with hand search. Results: Initial search identified 652 studies, shortlisted to 52 studies based on PRISMA. Quality assessment further led to final inclusion of 48 studies (13 moderately and 35 highly sensitive studies). Primary outcomes are significant upregulation in GCF levels of enzymes-aspartate aminotransferase (AST), alkaline phosphatase (ALP), matrix metalloproteinases (MMPs), lactate dehydrogenase (LDH), β-glucuronidase (βG), tartrate resistant acid phosphatase (TRAP), acid phosphatase (ACP) and down regulation in cathepsin B (Cb). Site specificity is shown by ALP, TRAP, AST, LDH, MMP9 with levels at compression site increasing earlier and in higher quantities compared with tension site. ALP levels are higher at tension site only in retention. A positive correlation of LDH, ALP and AST is also observed with increasing orthodontic force magnitude. Conclusions: A strong evidence of variation in enzymes (ALP, AST, ACP TRAP, LDH, MMPs, Cb) in GCF is found in association with different magnitude, stages and sites of orthodontic force application.

Effect of orthodontic force on the expression of PI3K, Akt, and P70S6 K in the human periodontal ligament during orthodontic loading.

The mammalian target of rapamycin (mTOR) is an atypical serine/threonine protein kinases involved in the regulation of cell growth, proliferation, and differentiation through the PI3K/Akt/mTOR/P70S6 K signalling pathway. P70S6 K as a downstream molecule of mTOR is activated by phosphorylation and subsequently promotes the synthesis of ribosomal and translational proteins. In this study, we investigated the role of PI3K, Akt, and P70S6 K in human periodontal tissue remodelling during orthodontic loading. The prepared tissue specimens taken from 4 extracted premolars were processed for immunolabelling. The changes in the expression of PI3K, Akt, and P70S6 K in the periodontal tissues were detected by real-time quantitative-polymerase chain reaction and Western blot analysis. The results from real-time quantitative-polymerase chain reaction and Western blot both showed that the expression of PI3K, Akt, and P70S6 K in the experimental group began to increase at 3days and increased significantly at 10days, then decreased approaching the control group level at 28days. Our findings showed that the expression of PI3K, Akt, and P70S6 K in human periodontal ligament demonstrated a variability during the orthodontic loading, which suggested that the PI3K/Akt/mTOR/P70S6 K signal pathway was involved in orthodontic tooth movement and played a role in the process of periodontium remodelling.

Authors' response

Authors' response

Effect of orthodontic force on expression levels of ten cytokines in gingival crevicular fluid

Various types of inflammatory mediators are involved in the cascade of biological events behind tissue remodeling allowing orthodontic tooth movement. This split-mouth longitudinal study aimed to evaluate the gingival crevicular fluid (GCF) levels of ten cytokines, IL-6, IL-8, IL-10, IL-13, IL-17, IFN-γ, GM-CSF, MCP-1, MIP-1β and TNF-α, during initial orthodontic treatment. The sample comprised 15 healthy patients (9 males and 6 females, 13.9±2.5 years). The lower (test) incisors were moved using fixed appliance carrying a 0.014-inch nickel titanium wire, whereas the upper (control) incisors were bonded without any force. The GCF was collected from the test and control teeth before fixed appliance mounting (baseline) and after 1, 7 and 21days. In 6 sites per tooth, from canine to canine, periodontal conditions were defined as the percentage of sites with visible plaque and bleeding on probing. The total GCF cytokines levels were quantified using multianalysis Luminex technology. Throughout the experimental term, and for both test and control teeth, the mean percentage of sites with visible plaque and bleeding on probing were generally below 25% and 15%, respectively, although variability was also seen. In the test teeth, the GCF levels of all the cytokines remained constant throughout the experimental term. On the contrary, significant reductions were seen in the control teeth for each cytokine. Moreover, significantly greater levels of IL-6, GM-CSF, MCP-1 and TNFα were seen in the test teeth as compared to the control teeth at 7days. The reasons for the differential behavior in the levels of all the investigated cytokines between the test and control teeth may be related to the presence of orthodontic forces and/or subclinical tissue inflammation. Further investigation is needed to elucidate potential roles for these biomarkers in the tissue remodeling incident to orthodontic tooth movement.

Pentraxin-3 Levels in Gingival Crevicular Fluid during Canine Retraction with Nickel-Titanium Coil Spring and Active Tieback.

Orthodontic treatment is routinely carried out in patients with the purpose of correcting various forms of dental malocclusions. Retraction of the canines can be achieved either individually or along with incisor. Pentraxin-3 (PTX-3) is regarded as the true independent indicator of disease activity. Hence, we undertook the present study to assess and compare the level of PTX-3 in patients undergoing canine retraction with active tieback and Nickel-Titanium (NiTi) coil spring. The present study included assessment of 25 patients that underwent canine retraction as a part of fixed orthodontic treatment. In the maxillary right and left quadrant, active tieback and NiTi coil spring were used respectively. Gingival crevicular fluid samples were collected 1 hour prior to the commencement of orthodontic canine retraction procedure followed by collection at following time intervals: 1 hour, 1, 7, and 14 days after the start of canine retraction procedure. Enzyme-linked immunosorbent assay kit was used for analysis of the samples as per manufacturer's instructions. All the data were recorded and compiled. All the results were analyzed by Statistical Package for the Social Sciences software. Nonsignificant difference was observed in the values of PTX-3 at baseline and 1 hour. While comparing the mean PTX-3 values between different time intervals in both the study groups, significant difference was observed. In comparison to the active tieback, NiTi coil exhibited faster space closure rate. In patients undergoing orthodontic treatment, PTX-3 is associated with periodontal remodeling under the effect of orthodontic forces.

The Effect of Orthodontic Forces on Tooth Response to Electric Pulp Test.

Introduction:The current study investigated the pulp response to electric pulp testing (EPT), before, upon initiation and one month after the start of orthodontic tooth movement. Methods and Materials:A total of 402 anterior teeth from 39 patients (mean age of 16.8±2.7 years) were examined in this non-controlled prospective study. The aligning forces were administered using initial NiTi archwires ligated on fixed appliances by using the MBT straight wire technique. The electrical stimulation was provided by the EPT. The EPT readings were recorded at three time points: before bonding (EPT0), immediately upon initiation (EPT1) and 1 month post-treatment (EPT2). The data were statistically analyzed by the ANOVA and Bonferroni tests (P<0.05). Results:Prior to bonding of the orthodontic brackets, the mean EPT value for all the experimental teeth was 3.42 EPT units. Upon initiation, the mean value of EPT1 for each tooth increased to 7.62 units. One month later, the mean EPT2 values dropped to 6.27 units. At this time point, 64 teeth (16%) of the experimental teeth failed to respond. The differences among EPT values at different time points were significant. There was no association between the EPT values and the location or the type of teeth. Conclusion:The physiological changes in the pulp affect the nerve fibers in the early stages of the orthodontic force application. As a result, thresholds to electrical stimulation would increase and the EPT may not initiate a response. Therefore results obtained by electrical pulp testing should be interpreted accordingly.

Effect of orthodontic forces on cytokine and receptor levels in gingival crevicular fluid: a systematic review.

This systematic review aimed to generate evidence on role of potent markers of inflammation [cytokines, chemokines, their associated receptors and antagonists] following the application of orthodontic forces. Subsequent to registration with PROSPERO, literature search followed a predetermined search strategy to key databases along with hand search (HS). Seventy-seven articles from PubMed (P), 637 from Scopus (S), 51 from Embase (E), and 3 from hand search (HS) were identified. A total of 39 articles were shortlisted that met strict inclusion and exclusion criteria and quality assessment. Each study was evaluated for participant characteristics, study design, oral hygiene regimen, and gingival crevicular fluid (GCF) handling. Among these studies, biomarkers in the order of frequency were interleukin (IL)-1β (N = 21), tumor necrosis factor (TNF)-α (N = 10), IL-8,IL-6(N=8), receptor activator of nuclear factor kappa-B ligand (RANKL) (N = 7), monocyte chemoattractant protein (MCP)-1 (N = 3), IL-2 (N=4), IL-4, IL-10, RANTES (N = 2), IL-1, IL-5, IL-1α, IP-10, osteopontin (OPN) (N = 1) and receptors and their antagonists in the order of osteoprotegerin (OPG) (N = 8), IL-1RA (N = 5), and RANK (N = 1). Results revealed an immediate release of inflammatory bone-resorptive mediators, IL-1β and TNF-α, where IL-1β increased as early as 1 min to 1 h reaching peak at 24 h while TNF-α increased at 1 h or 1 day. This was accompanied by a fall in bone-protective mediator (OPG) levels at 1 h and 24 h after orthodontic force application. Continuous forces were accompanied by a decrease in mediator levels after attaining peak levels (most commonly at 24 h) while repeated activations in interrupted force upregulated their secretion. Significant correlations of IL-1β levels with pain intensity, rate of orthodontic tooth movement (OTM) and of activity index (AI) (IL-1β/IL-1RA) with velocity of tooth movement and growth status of individuals have also been deduced. A greater AI and RANKL/OPG ratio was seen in juveniles as compared to adults or non-growers that were associated with faster rate of OTM in juveniles. None of the studies addressed the effect of estrous cycle in female subjects. Lack of homogeneity in several parameters calls for a better controlled research on the biology of OTM.Electronic supplementary materialThe online version of this article (doi:10.1186/s40510-014-0065-6) contains supplementary material, which is available to authorized users.

Effect of orthodontic force on expression of Asporin after tooth auto-transplantation: an experimental study in Beagle dogs

To evaluate the effect of orthodontic light force on the expression of Asporin, bone morphogenetic proteins-2 (BMP-2) and alkaline phosphatase (ALP) after auto-transplantation. Thirty-two maxillary and mandibular incisors in four 13 month-old male Beagle dogs were auto-transplanted to the other side of the same jaw. The teeth were all endodontically treated and divided into four groups, control (group 1) and three experimental groups (groups 2, 3 and 4).In control group, the teeth were unloaded. In the other three experimental groups, continuous force was applied in the 1st week (group 2), 2nd week (group 3) and 4th week (group 4) after auto-transplantation, respectively. The dogs were sacrificed in the 8th week. The mRNA expressions of Asporin,BMP-2 and ALP were examined by real time PCR. The expression of periodontal ligament associated protein-1 (PLAP-1) was examined by Western blotting. The data were statistically analyzed using SPSS 17.0 and one-way analysis of variance (ANOVA). In group 3, the expression of Asporin mRNA (2.047 ± 0.281) was higher than that in the other three groups, while the expression of BMP-2 (1.358 ± 0.095) was lower than that in group 2 and control group (P < 0.05). The expression of PLAP-1 (1.054 ± 0.113) in group 3 was higher than other groups, while significant difference was found between any two groups. Orthodontic force could stimulate the expression of Asporin and PLAP-1. The orthodontic force applied in the 2nd week after the tooth auto-transplantation, the expression of Asporin and PLAP-1 reached the highest level.

Orthodontic-Periodontic Interdisciplinary Approach

AbstractIn the last years, a significant development has taken place in the orthodontic treatment of adult Patients. Adult orthodontics is different than that for children because in adults there is virtual no more growth and because there are changes in the tooth supporting structures: the periodontium. The orthodontic treatment is carried out through the medium of periodontium so a healthy tooth supporting system is the essential prerequisite for carrying out the orthodontic treatment. At the same time, as the tooth is moving under the effect of orthodontic force, various changes occur in the periodontium under the effect of force. So, it is important that the orthodontic treatment is periodontally compromised patient be considered separately as they are more prone to further bone loss; the reduced periodontium cannot sustain further loss without the potential loss of teeth. The reduced periodontal support dictates altered treatment design, mechanics and retention. At the same time it is important to consider the limits of periodontium while carrying out orthodontic treatment so that there is no damage due to inadvertent intervention.

Effect of orthodontic force on periodontal healing after autotransplantation: an experimental study

To investigate the effect of the continuous light force to the donor teeth on the periodontal healing after transplantation. Thirty-two maxillary and mandibular incisors in four 10-month-old male Beagle dogs were autotransplanted. The pulps were removed in all teeth. The teeth were divided into four groups, one control and three experimental groups. In control group (group 1), the teeth were unloaded. In the other three experimental groups, continuous force (0.49 N) was applied in the 1st (group 2), 2nd (group 3) and 4th (group 4) week, respectively. The dogs were sacrificed in the 8th week. The tissue blocks were demineralized and sectioned perpendicular to the long axis of the teeth. The histological analysis was made. Histomophometric analysis revealed a significantly lower occurrence of replacement root resorption in the group 3 (2.1%) than in the control group (12.5%, P < 0.05). The significant lower incidence of replacement root resorption, and a higher surface and inflammatory root resorption were found in group 2 (6.3% and 68.8%) than in the control group (12.5% and 41.7%, P < 0.05). No significant difference was found between group 4 and control group (P > 0.05). The orthodontic force promoted the regeneration of the periodontal ligament and prevented dentoalveolar ankylosis, whereas excessive initial force might cause root and bone resorption.

The Effect of Orthodontic Forces on Calcitonin Gene-related Peptide Expression in Human Dental Pulp

Introduction The purpose of this study was to quantify the effect of moderate and severe orthodontic forces on calcitonin gene-related peptide (CGRP) expression in healthy human dental pulp. Methods Thirty human dental pulp samples were obtained from healthy premolars in which extraction was indicated for orthodontic reasons. Before extraction, teeth were divided into 3 groups of 10 premolars each: (1) the control group: healthy premolars without application of orthodontic forces; (2) the moderate force group: a 56-g force was applied to the premolars for 24 hours; and (3) the severe force group: a 224-g force was applied to the premolars for 24 hours. All dental pulp samples were processed, and CGRP was measured by radioimmunoassay. Results Greater CGRP expression was found in the severe force group followed by the moderate force group. The lower CGRP values were for the control group. The Kruskal-Wallis test showed statistically significant differences between groups ( P < .0001). Least significant difference (LSD) post hoc tests showed statistically significant differences in CGRP expression between the control group and the severe force group ( P < .0001) but not with the moderate force group ( P = .06). Differences between the moderate and severe force groups were statistically significant ( P < .0001). Conclusions CGRP expression in human dental pulp increases when teeth are submitted to severe orthodontic forces.

Le déplacement dentaire orthodontique : histologie, biologie et effets iatrogènes

Iatrogenic effects of orthodontic forces, in particular root resorption, are described in the literature. However, our knowledge on the risk of osseous defects induced by orthodontic treatment is still scarce. After an overview of histological and biological principles of orthodontically-induced tooth movement, this study focuses on the recent data concerning the occurrence and the treatment of bone resorption associated with orthodontic treatment.