Effects Of Orthodontic Tooth Movement Research Articles

Orthodontic mechanotherapies and their influence on external root resorption: A systematic review.

This systematic review assesses the literature regarding the association between orthodontic tooth movement and external root resorption. By determining the evidence level supporting the association, the results could provide clinical evidence for minimizing the deleterious effect of orthodontic tooth movement. Electronic databases, including MEDLINE, PubMed, Embase, Scopus, CINAHL, Cochrane Library, and LILACS, were searched up to February 2018, with hand searching of selected orthodontic journals undertaken to identify any preelectronic publications. Searches were undertaken with no restrictions on year, publication status, or language. Selection criteria included randomized controlled trials conducted with the use of fixed orthodontic appliances or sequential thermoplastic aligners on human patients. The quality of included studies was assessed with the use of the Cochrane Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Inter-rater agreement of the review authors was used for the inclusion of primary articles, risk of bias assessment, and evaluation of the quality of evidence (GRADE), and it was calculated with the use of the Cohen kappa statistic. A total of 654 articles were retrieved in the initial search. After the review process, 25 articles describing 24 individual trials met the inclusion criteria. Sample sizes ranged from 6 to 154 patients. Most articles were classified as having unclear risks of bias and very low to low quality of evidence. There is very low to low evidence for supporting positive associations between root resorption and increased force levels, force continuity, intrusive forces, and treatment duration. Moreover, by including a pause in treatment for patients experiencing root resorption, it may be possible for the clinician to reduce the severity of the condition. Of the included studies, the most common methodologic flaws include the absence of a control group, appropriate randomization strategy, and adequate examinations before and after treatment.

Optimal management of orthodontic pain.

Pain is an undesirable side effect of orthodontic tooth movement, which causes many patients to give up orthodontic treatment or avoid it altogether. The aim of this study was to investigate, through an analysis of the scientific literature, the best method for managing orthodontic pain. The methodological aspects involved careful definition of keywords and diligent search in databases of scientific articles published in the English language, without any restriction of publication date. We recovered 1281 articles. After the filtering and classification of these articles, 56 randomized clinical trials were selected. Of these, 19 evaluated the effects of different types of drugs for the control of orthodontic pain, 16 evaluated the effects of low-level laser therapy on orthodontic pain, and 21 evaluated other methods of pain control. Drugs reported as effective in orthodontic pain control included ibuprofen, paracetamol, naproxen sodium, aspirin, etoricoxib, meloxicam, piroxicam, and tenoxicam. Most studies report favorable outcomes in terms of alleviation of orthodontic pain with the use of low-level laser therapy. Nevertheless, we noticed that there is no consensus, both for the drug and for laser therapy, on the doses and clinical protocols most appropriate for orthodontic pain management. Alternative methods for orthodontic pain control can also broaden the clinician’s range of options in the search for better patient care.

Biological Effects of Orthodontic Tooth Movement Into the Grafted Alveolar Cleft

Functional stimulus during orthodontic tooth movement into the grafted bone can lead to better alveolar bone grafting outcomes. The aim of this study was to analyze the biological effects of orthodontic tooth movement into the grafted alveolar cleft area with histologic staining, fluorescence staining, and real-time polymerase chain reaction (PCR). An animal model of orthodontic tooth movement into the grafted alveolar cleft area was established in 8-week-old Sprague-Dawley rats. The animals were divided into the experimental group and the control group. Four checkpoints were observed: before orthodontic stimuli, day 1 after orthodontic stimuli, day 3 after orthodontic stimuli, and day 5 after orthodontic stimuli. The cleft bone formation conditions, including the collagen fibers and the activities of the osteoclasts and osteoblasts, were evaluated by histologic staining. The expression of tartrate-resistant acid phosphatase (TRAP), receptor activator nuclear factor κB ligand, and Runt-related transcription factor 2 was detected by real-time PCR in both groups. Hematoxylin-eosin staining showed that the remodeling process of iliac autografts was completed when the orthodontic stress was applied, whereas the bone tissues first showed osteoclastogenesis and then osteogenesis. On the basis of TRAP staining, the osteoclasts increased to the maximal amount on day 3 and decreased thereafter. Evidence from tetracycline fluorescence staining indicated that no obvious changes in osteoblast activity were detected at the early stage; however, it gradually increased, especially in the region close to the root surface. According to real-time PCR, the expression of TRAP increased in both the early and middle stages, that of receptor activator nuclear factor κB ligand increased in the early stage, and that of Runt-related transcription factor 2 increased in the late stage. Moreover, the results showed significant differences between the experimental and control groups. Orthodontic tooth movement into the alveolar cleft bone graft area promoted bone remodeling of embedded bone, thus inducing bone resorption and subsequent deposition.

Biochemical markers of bone metabolism during early orthodontic tooth movement with aligners.

To evaluate the expression of receptor activator of nuclear factor-kappa ligand (RANKL), osteoprotegerin (OPG), osteopontin (OPN), interleukin 1β (IL-1β), and transforming growth factor ß1 (TGF-ß1) in the gingival crevicular fluid (GCF) of teeth subjected to orthodontic forces released by aligners. A total of 10 healthy, adult patients were selected to participate in this split-mouth study. The treatment plan was designed to obtain only one movement with the first aligner: distalization of a second molar. GCF samples were obtained from pressure and tension sites of the test tooth and from the mesiobuccal and distobuccal sites of the control tooth. The GCF sample volumes were measured using a Periotron 8000. Levels of TGF-β, IL-1β, RANKL, OPG, and OPN were measured by enzyme-linked immunosorbent assay. IL-1β showed a significant increase at the pressure sites after 1 week and 3 weeks with respect to baseline (P < .05) compared with control sites. The kinetics of TGF-1β and OPN were characterized by a significant increase at the tension sites of the test teeth (P < .05) after 3 weeks from the application of orthodontic force. The RANKL level was significantly increased at pressure and tension sites after 1 hour and after 1 week from the application of the orthodontic forces (P = .023 and P = .043, respectively). An increased concentration of bone modeling and remodeling mediators at the pressure sites (IL-1β, RANKL) and tension sites (TGF-1β, OPN) was observed. These scenarios are compatible with previous in vivo and in vitro studies investigating the biological effects of orthodontic tooth movement.

Age-related changes of dental pulp tissue after experimental tooth movement in rats.

It is generally accepted that the effect of orthodontic tooth movement on the dental pulp in adolescents is reversible and that it has no long-lasting effect on pulpal physiology. However, it is not clear yet if the same conclusion is also valid for adult subjects. Thus, in two groups of rats, aged 6 and 40 weeks respectively, 3 molars at one side of the maxilla were moved together in a mesial direction with a standardized orthodontic appliance delivering a force of 10 cN. The contralateral side served as a control. Parasagittal histological sections were prepared after tooth movement for 1, 2, 4, 8, and 12 weeks. The pulp tissue was characterized for the different groups, with special emphasis on cell density, inflammatory cells, vascularity, and odontoblasts. Dimensions of dentin and the pulpal horns was determined and related with the duration of orthodontic force application and age ware evaluated. We found that neither in young nor in adult rats, force application led to long-lasting or irreversible changes in pulpal tissues. Dimensional variables showed significant age-related changes. In conclusion, orthodontic tooth movement per se has no long-lasting or irreversible effect on pulpal tissues, neither in the young nor in the adult animals.

Effect of Orthodontic Tooth Movement on Salivary Aspartate Aminotransferase Activity

72 1024x768 Aspartate aminotransferase is one of biological indicator in gingival crevicular fluid (CGF). Force orthodontic application could increase activity of aspartate aminotransferase in CGF. However, the increase activity of aspartate aminotransferase in saliva due to orthodontic force and its correlation between aspartate aminotransferase activity and tooth movement remains unclear. Objectives: To evaluate application orthodontic force on the aspartate aminotransferase activity in saliva based on the duration of force and finding correlation between tooth movement and aspartate aminotransferase activity. Methods: Twenty saliva samples collected before extraction of first premolar, at the time of force application for canine retraction and after force application. The canines retraction used 100 grams of interrupted force (module chain) for thirty days. The collection of saliva and the measurement of tooth movement were carried out 1 day, 7 days, 14 days, 21 days, and 28 days after force application. The measurement of aspartate aminotransferase activity in saliva was done using spectrophotometer. Results: Application of orthodontic force influences the salivary aspartate aminotransferase activity (F=25.290, p =0.000). Furthermore, tooth movement correlated with aspartate aminotransferase activity (F=0.429, p =0.000). Conclusion: Aspartate aminotransferase activity could be used as tooth movement indicator that related to the duration of force application. DOI : 10.14693/jdi.v20i1.128

Development of a three-dimensional in vitro model system to study orthodontic tooth movement

Few three-dimensional (3-D) models exist to study the cellular aspects and molecular regulation of orthodontic tooth movement (OTM). The aim of this study was to develop a 3-D in vitro model to study mechanical loading of human periodontal ligament (PDL) fibroblasts (hPDLF). hPDLF were seeded within collagen gels to form a PDLF analogue. Characterisation of the seeded collagen gels revealed that the gels supported cell proliferation, viability and the emergence of a possible contractile phenotype, replicating the constrained condition of the human PDL in vivo. We next developed a 3-D model that incorporated a seeded collagen gel interlocked mechanically at two ends to movable end plates. The movable end plates allowed for static tensile or compressive loading of the hPDLF-seeded collagen gels. Preliminary testings showed that this 3-D model mimicked PDL strains similar to those observed during OTM. Our 3-D model of OTM therefore offers promise for use as a model system in future studies to improve our understanding of the effects of OTM on PDLF.

Effect of orthodontic tooth movement on salivary levels of Interleukin-1beta, Tumor Necrosis Factor-alpha, and C- reactive protein

Orthodontic force is considered to stimulate cells in the periodontium to release many mediators such as cytokines which play a responsible role for periodontal and alveolar bone remodeling, bone resorption and new bone deposition. Aim of this study was carried out to estimate changes of the (interleukin-one beta, tumor necrosis factor - alpha and C-reactive protein) levels in unstimulated whole saliva during the leveling stage of orthodontic tooth movement. Materials and methods: The sample consisted of thirty adult patients (12 males and 18 females) with ages ranges (19- 23) years. Each sample had Class I and Class II malocclusion dental classification and required bilateral extraction of their maxillary first premolars, underwent a session of professional oral hygiene and received oral hygiene instructions before and during the period of study, one month later fixed orthodontic appliance were placed in the upper arch by using 0.014 nickel titanium arch wire. The unstimulated whole saliva was taken from each sample immediately before placement of the appliance (baseline), and at (after1hour, after one week and after two week) following placement of the fixed orthodontic appliance. In addition the plaque index and gingival index were recorded during the interval periods of this study to assess oral cleanliness. The interleukin - one beta and tumor necrosis factor- alpha were determined by enzyme linked immunosorbent assay, while the C-reactive protein was determined by latex agglutination. Results: The results of the present study found the mean value of both salivary (interleukin-one beta and tumor necrosis factor -alpha) were highest at (after1hour) followed by at (after one week) then at (after two week) than the baseline with highly statistical significant differences (P 0.05). While the mean values of C-reactive protein were higher at (after 1hour) only with highly significant differences (P< 0.01) among females and total samples while only significant difference (P<0.05) for males, in addition there were no statistical significant differences between males and females. Regarding the correlation between salivary (interleukin - one beta and tumor necrosis factor -alpha), there were positive correlation between them at all periods of study. Moreover there were positive correlation between salivary (interleukin - one beta and tumor necrosis factor -alpha) and salivary C- reactive protein. On the other hand there were no association between the salivary (interleukin - one beta and tumor necrosis factor -alpha and C-reactive protein) and clinical parameter (plaque index and gingival index). Conclusion: From this clinical study we conclude that orthodontic force induces increasing the levels of (interleukin - one beta, tumor necrosis factor -alpha, C-reactive protein) in unstimulated whole saliva during orthodontic tooth

Effect of Orthodontic Tooth Movement on Salivary Levels of Interleukin - 1beta , Tumor Necrosis Factor - Alpha , and Creactive Protein

Effect of Orthodontic Tooth Movement on Salivary Levels of Interleukin - 1beta , Tumor Necrosis Factor - Alpha , and Creactive Protein

Orthodontic tooth movement causes decreased promoter expression of collagen type 1, bone sialoprotein and alpha‐smooth muscle actin in the periodontal ligament

To evaluate the effects of orthodontic tooth movement on the promoter expression of collagen type 1 (3.6Col1), bone sialoprotein (BSP) and alpha-smooth muscle actin (αSMA) in the periodontal ligament (PDL) using transgenic mice containing transgenes of these promoters fused to green fluorescent proteins (GFP). The maxillary first molars of 10-12 week-old transgenic mice were loaded with 10-12 g of force for 12, 48 h, or 7 days. Mice were transgenic for one of the following GFP-tagged bone markers of osteoblast lineage cells: 3.6-kb fragment of the rat collagen type 1 promoter (3.6Col1), BSP or α-smooth muscle actin (αSMA). Loaded molars under compression and tension were compared with contra-lateral unloaded controls. On the compression side of the PDL, orthodontic tooth movement caused a significant decrease in GFP expression of all the promoters at each time point. On the tension side, there was a significant increase in BSP-GFP expression, 12 h following loading compared to the contralateral unloaded controls. An in vivo tooth movement model using transgenic mice with promoter-GFP constructs provides an efficient and effective way of investigating the cellular events underlying orthodontic tooth movement. PDL cells may undergo decreased differentiation in response to the compressive force.

Responses of pulp sensibility tests during orthodontic treatment and retention

To investigate the effect of orthodontic tooth movement involving the six maxillary anterior teeth on the pulp response to both thermal and electric stimuli during active orthodontic treatment and retention. Forty-seven subjects who required fixed orthodontic appliances were used as a study group with 23 non-orthodontic subjects recruited as a control group. Cold and electrical stimuli were applied to the maxillary incisors and canines immediately before and after the placement of fixed appliances and at regular intervals for both groups during active treatment and 12 months into retention. The numbers of negative responses for each tooth at each time interval were recorded for both groups. The data were collected and tabulated, and chi-square tests were used to determine significant difference between the numbers of negative responses for the two types of tests used on the same tooth and between different teeth. The mean values of the electric pulp testing (EPT) thresholds were also obtained and used to assist in analysing the results. In the control group, all teeth tested positively to the EPT and thermal pulp tests at all time intervals. In the orthodontic group, two teeth failed to respond to EPT and only one tooth to thermal testing at baseline (Time 0). After that, the number of negative responses to both tests increased gradually at each time interval reaching a peak after 2 months of active treatment (Time 3) and then declined gradually towards the end of observation period (Time 14). At baseline, response thresholds to electric testing were typically higher for orthodontic subjects, particularly for the maxillary lateral incisor tooth. For the control group, the response threshold over the study period was relatively constant. For the orthodontic group, application of force immediately increased the response threshold to EPT (Time 1), which peaked after 2 months (Time 3) and then gradually reduced. At the end of the active treatment, response thresholds remained elevated, but they returned to pre-treatment values towards the end of the retention phase. Dental practitioners should interpret responses to electrical pulp testing cautiously in orthodontic patients; thermal testing may be more reliable.

The Orthodontist's Role in 21st Century Periodontic-Prosthodontic Therapy

Often orthodontists can be of considerable assistance in periodontal and prosthodontic treatment. The orthodontists' principle periodontal objective with so-called facilitative care is to reduce or prevent excessive periodontal surgery by establishing a physiologic alveolar crestal topography. This can be done by recognizing the effect of orthodontic tooth movement (OTM) on the alveloar topography and engineering the desired contour with selective force gradients in concert with minor periodontal surgery.With this synergistic orchestration between specials the prosthetic foundation is more stable, the esthetic contour of the gingiva is improved and, most important, unnecessary removal of alveolar bone is avoided because pathologic contours due to tooth malalignment are eliminated prior to osseous surgery. Case studies are integrated herein with emerging 21st century concepts of periodontal tissue engineering

Identification of dentine sialoprotein in gingival crevicular fluid during physiological root resorption and orthodontic tooth movement

Root resorption is an unwanted effect of orthodontic tooth movement. Analysis of dentine proteins in gingival crevicular fluid (GCF) is a potentially safer method of quantifying root resorption compared with conventional radiographic methods. This study aimed to identify and quantify the dentine-specific matrix protein, dentine sialoprotein (DSP), released into GCF during physiological root resorption and orthodontic tooth movement. GCF was collected using micropipettes from 50 second primary molar sites undergoing physiological root resorption in 9- to 14-year olds [coronal group (Rc) with advanced resorption (n = 33) and apical group (Ra) with minimal resorption (n = 17)] and 20 subjects aged 8-14 years with erupted mandibular second premolars (control group). In addition, GCF was collected from 20 patients undergoing treatment with fixed appliances at two time points, immediately prior to orthodontic intervention (T0) and 12 weeks following commencement of fixed appliance therapy (T1). GCF samples were analysed for DSP using an immunoassay and levels semi-quantified using image analysis. To determine differences between the means of the various experimental and control groups, data based on the relative optical density volumes, were statistically analysed using a parametric t-test. DSP was raised in sites that were undergoing physiological resorption compared with the non-resorbing controls (P < 0.05). Notably, DSP was detected in some control samples. There was no difference in DSP levels for the Rc or Ra groups. DSP was also raised in GCF samples of teeth at 12 weeks following commencement of fixed appliance therapy (P < 0.001). The results highlight the potential for measuring DSP in GCF as a biomarker to monitor root resorption. Dentine is likely to be the major source for DSP in GCF, although alternative origins of bone and cementum are possible.

Gingiva and Orthodontic Treatment

Orthodontic appliances, as well as mechanical procedures, are prone to evoke local soft-tissue responses in the gingiva. These effects can either be of positive nature, (physiologic recontouring), helping tooth movement, or negative ones, which should be avoided. The main source of negative outcomes involves orthodontic attachments, which inhibit efficient removal of bacterial biofilms (dental plaque). Undesirable complications are often due to an understandable lack of awareness while the orthodontist focuses on biomechanical matters. While conscientious attention to biomechanical progress justifies this focus, close attention should be paid to infection control and the possibility of iatrogenic side effects. This article considers the issues of ideal orthodontic clinical management as well as those of inadequate patient compliance and infection management. Exactly how therapeutic, prophylactic, and anti-infective issues are assumed or delegated by the orthodontist, patient, or the referring dentist is a matter of individual practice style and an integral part of the doctor-patient covenant. This article attempts to provide current information regarding clinical, microscopic, and molecular level effects of orthodontic tooth movement on gingival tissues during fixed appliance therapy, or remedial methods once orthodontic appliances are removed. Orthodontic appliances, as well as mechanical procedures, are prone to evoke local soft-tissue responses in the gingiva. These effects can either be of positive nature, (physiologic recontouring), helping tooth movement, or negative ones, which should be avoided. The main source of negative outcomes involves orthodontic attachments, which inhibit efficient removal of bacterial biofilms (dental plaque). Undesirable complications are often due to an understandable lack of awareness while the orthodontist focuses on biomechanical matters. While conscientious attention to biomechanical progress justifies this focus, close attention should be paid to infection control and the possibility of iatrogenic side effects. This article considers the issues of ideal orthodontic clinical management as well as those of inadequate patient compliance and infection management. Exactly how therapeutic, prophylactic, and anti-infective issues are assumed or delegated by the orthodontist, patient, or the referring dentist is a matter of individual practice style and an integral part of the doctor-patient covenant. This article attempts to provide current information regarding clinical, microscopic, and molecular level effects of orthodontic tooth movement on gingival tissues during fixed appliance therapy, or remedial methods once orthodontic appliances are removed.

Periodontal healing following orthodontic movement of rat molars with intact versus damaged periodontia towards a bony defect

The aim of this research was to determine whether orthodontic tooth movement influences periodontal healing. In 16 male Wistar rats, 12 week of age, a bony defect was created mesial to both maxillary first molars, not including the attachment apparatus (group 1), and in 15 animals, the defect included the periodontal ligament (group 2). In both groups, the right first molar was moved mesially (orthodontic side) for 2 weeks followed by a 1-week retention period; the contralateral molar was not moved (control side). Histomorphometric analysis was performed. The results within and between the different treatment groups and sides were statistically compared by t-test and analysis of variance with repeated measures on logarithmic transformation. Junctional epithelium was significantly larger at the control than at the orthodontic side of both groups (P = 0.024), and significantly larger in group 2 than in group 1 (P < 0.001). A significantly (P = 0.034) larger pocket depth was found at the control side in group 1. Supracrestal connective tissue was larger at the control than at the orthodontic side for both groups and significantly larger in group 2 than in group 1 (P = 0.004). Root resorption was found infrequently only at the orthodontic side in both groups (five out of 31 cases). The principal findings suggest favourable effects of orthodontic tooth movement on restraining epithelial apical down-growth and decreasing pocket depth. Orthodontic treatment could not completely avoid formation of a long epithelial attachment. Therefore, periodontal regenerative surgery might be indicated prior to orthodontic tooth movement. Orthodontic movement, shortly after periodontal surgery, had no detrimental effect on periodontal soft tissue healing or on diminished but non-inflamed periodontal tissues.

Galanin-immunoreactive nerve fibers in the periodontal ligament during experimental tooth movement.

Neuropeptides have been suggested to play a role in pain transmission during orthodontic tooth movement. We examined this hypothesis by examining the effect of orthodontic tooth movement on the expression of galanin (GAL)-immunoreactive (ir) nerve fibers in the periodontal ligament (PDL) of one mesial root (MR) and two distal roots (DRs) of the rat maxillary first molar. In control rats, GAL-ir fibers were very rare in the PDL. One day after the insertion of the elastic band, the number of GAL-ir fibers increased, becoming most numerous at 3 days. From 5 to 28 days, GAL-ir fibers tended to decrease. Electron microscopic observation showed that all of the GAL-ir fibers were unmyelinated. These findings suggest that GAL-containing nerve fibers in the PDL may play an important role in the response of the tissue to experimental tooth movement.

Gingival response to orthodontic force

Orthodontic tooth movement is brought about by prolonged application of force on the attachment apparatus. This results in cellular and extracellular changes within the periodontium. As shown in numerous studies, tooth movement is achieved after the remodeling of alveolar bone and the response of the periodontal ligament to the mechanical force. Although gingival changes have also been found to be an important factor in the overall response, the effect of orthodontic tooth movement on the gingiva has been investigated to a lesser extent. Unlike bone and periodontal ligament, which regain their original structure after removal of force, the gingival tissue does not regain its pretreatment structure, a fact on which a hypothesis has been made that tooth relapse after removal of retention may be associated with changes in the gingiva. The present review summarizes available data on the effect of orthodontic force on collagen, elastin, and collagenase in the gingiva and its relevance to understanding the mechanism of tooth relapse. (Am J Orthod Dentofacial Orthop 1999;116:152-8)

Distraction Osteogenesis

The application of distraction osteogenesis in craniomaxillofacial surgery has created new treatment methods for patients with craniofacial skeletal dysplasias. Most of the applications in the craniofacial skeleton have been for the correction of severe congenital or acquired conditions. As more understanding is gained with these new approaches, refinements in techniques will enhance treatment planning and outcome. This will expand the application of distraction osteogenesis to more common, less severe types of skeletal dysplasias. One of the important areas in mandibular distraction osteogenesis is the management of the dental gap created when distraction is applied within the tooth-bearing segment of the mandibular body. In this study, the authors investigated the effects of orthodontic tooth movement into new bone created through the process of distraction osteogenesis. Orthodontic tooth movement through newly formed mandibular bone in the canine model was performed and, through histologic studies, was found to create compact bone along the path of the moving tooth. This compact bone replaced the more unstructured woven bone that was originally created by the process of mandibular distraction osteogenesis. These findings indicate that orthodontic tooth movement can be performed in distracted bone and can have significant influence on the stability and long-term structural preservation of the bone created by distraction osteogenesis within the tooth-bearing segment of the mandible.

The effects of early orthodontic force application on pulp test responses.

The effects of orthodontic tooth movement on pulpal responses are of interest to the clinician. Alterations to pulpal physiology may result in altered responses to external stimuli. This pilot project tested a small group of orthodontic patients during the early stages of treatment. Heat, cold and electrical stimuli were applied prior to treatment, after the placement of fixed appliances and after one month of force application. A smaller group was tested after two months of force application. One month after force application there was a lack of response to electrical stimulation but there was continued response to thermal stimulation. The lack of response to electrical stimulation continued in the smaller group up to two months. The results suggest that the outcome of electric pulp testing during orthodontic treatment should be interpreted cautiously. Thermal testing will offer more reliable data.

The effects of orthodontic tooth movement on the glycosaminoglycan components of gingival crevicular fluid

In this study, gingival crevicular fluid (GCF) was collected from around a canine tooth, in children, before and during orthodontic tooth movement. The aim was to identify and quantify the glycosaminoglycan (GAG) components of GCF and relate them to tooth movement, gingival inflammation, plaque accumulation, pocket probing depth and GCF volume recorded at the site of sampling. GAG in GCF samples, collected for a 15-min period into microcapillary tubes, were separated electrophoretically, stained with Alcian blue and quantified using a laser densitometer. 2 GAG components of hyaluronic acid (HA) and chondroitin sulphate (CS) were identified. The increase in GCF volume during orthodontic tooth movement was only partly due to increased gingival inflammation. GAG levels varied with different types of orthodontic tooth movement. In GCF, levels of CS, in particular, may reflect the changes in the deeper periodontal tissues which could be monitored during orthodontic tooth movements.