scholarly journals Ultrasonographic evaluation of periodontal changes during orthodontic tooth movement - work in progress

2017 ◽  
Vol 90 (1) ◽  
pp. 93-98
Author(s):  
Adela Zimbran ◽  
Diana Dudea ◽  
Cristina Gasparik ◽  
Sorin Dudea

Background and aim. Orthodontic tooth movement (OTM) is a process whereby the application of a force induces bone resorption on the pressure side and bone apposition on the tension side of the lamina dura. However, only limited data are available on the in vivo behavior of the periodontal tissues. The aim of this study was to assess the changes of periodontal tissues, induced by the orthodontic canine retraction, using 40 MHz ultrasonography.Methods. Ultrasonographic evaluation of periodontal tissues was conducted in 5 patients with indication for orthodontic treatment. The upper first premolars were extracted bilaterally due to severe crowding, and the canines were distalized using elastomeric chain with a net force of 100 cN. Ultrasonographic scans (US scans) were performed before, during and after retraction, in three distinct areas of the canines buccal surface: mesial, middle and distal. The reference point was the bracket, which appeared hyperechoic on the US scan. Four different dimensions were obtained: D1 (depth of the sulcus), D2 (thickness of the gingiva), D3 (length of the supracrestal fibers), D4 (width of periodontal space).Results. An increase of D1 was observed in all three areas of the periodontium, during orthodontic treatment.  D3 was strongly correlated before and immediately after force delivery only for the mesial area (r=0.828, p<0.05). In total, 228 variables were statistically analyzed using Pearson’s correlation coefficients, in order to demonstrate the relationship between periodontal findings during orthodontic tooth movement.Conclusions. High-resolution ultrasonography has the capability to obviate changes in periodontal ligament space and free gingiva during orthodontic tooth movement.

2021 ◽  
Vol 11 (2) ◽  
pp. 521
Author(s):  
Simina Chelărescu ◽  
Petra Șurlin ◽  
Mioara Decusară ◽  
Mădălina Oprică ◽  
Eugen Bud ◽  
...  

Background: The crevicular fluid analysis represents a useful diagnosis tool, with the help of which noninvasive cellular metabolic activity can be analyzed. The aim of the study is to investigate comparatively IL1β and IL6 in the gingival crevicular fluid of clinically healthy adolescents and young adults during the acute phase of orthodontic treatment. Methods: Gingival crevicular fluid was collected from 20 patients (aged between 11 and 28) undergoing orthodontic treatment. Measurements were taken before (T0) and after 24 h after distalization forces were activated (T1). IL1β and IL 6 were analyzed using Elisa tests. The statistical tests used were two-sided t tests. Results: Between the two time periods there was a significant raise both in the crevicular fluid rate (0.57 µL at T0 vs. 0.95 µL at T1, p = 0.001) and in IL1β levels (15.67 pg/µL at T0 vs. 27.94 pg/µL at T1, p = 0.009). We were able to identify IL6 only in a third of the sites. There is a significantly increased level of ILβ at T1 in adolescents, more than in young adults (42.96 pg/µL vs. 17.93 pg/µL, p = 0.006). Conclusions: In the early stage of orthodontic treatment, the periodontal tissues of adolescents are more responsive to orthodontic forces than those of young adults.


2017 ◽  
Vol 11 (1) ◽  
pp. 466-475 ◽  
Author(s):  
Taísa Boamorte Raveli ◽  
Dirceu Barnabé Raveli ◽  
Kelei Cristina de Mathias Almeida ◽  
Ary dos Santos Pinto

Background: Tipped lower molar over edentulous space is very common in orthodontics practice when adults seek treatment. The segmented arch technique features a predictable force system that provides a controlled release of force that can produce light and continuous tooth movement. Case Description: A female adult patient, who lost a permanent lower first molar, needed correction of the position of her permanent first molar place. Instead of making space for rehabilitation, it was closed after second molar uprighting and a balanced interdigitation was created without prosthetics. The patient was successfully treated with segmented arch technique using root correction spring activated with geometry VI to promote uprighting of a tipped molar and Niti spring coil to promote space closure. Practical Implications: Segmented arch technique is known to provide predictable light and continuous forces, which is very much indicated in adult treatment. There are several things to consider when orthodontically treating adult patients. Their periodontal conditions might not be ideal, less bone apposition may occur, and side effects of orthodontic tooth movement are expected. Thus, a predictable and controlled orthodontic treatment is needed.


2017 ◽  
Vol 16 ◽  
pp. 1-8
Author(s):  
Noraini Abu Bakar ◽  
Wisam Kamil ◽  
Lina Al Bayati ◽  
Basma Ezzat Mustafa

Introduction: During orthodontic tooth movement, the early response of periodontal tissues to mechanical stress is an acute inflammatory reaction. Mechanical stress from orthodontic appliances is believed to induce cells in the periodontal ligament (PDL) to form biologically active substances, such as enzymes and cytokines, responsible for connective tissue remodeling (Nishijima Y et al 2006). Leptin, a polypeptide hormone has been classified as a cytokine (Zhang et al 1994). Earlier findings concluded that leptin at high local concentrations protects the host from inflammation and infection as well as maintaining bone levels. It has been also suggested that leptin plays a significant role in bone formation by its direct effect on osteoblasts (Alparslan et al 2010). This pilot study aimed to study leptin in saliva and its association with tooth movement during initial orthodontic alignment. Objectives: To determine if there are any differences in saliva leptin level before and after orthodontic alignment. Material and methods: Ten orthodontic patients (7 girls and 3 boys; mean age, 16.76 ± 1.1 years) with crowding (up to 5mm) that required orthodontic fixed appliances, on a non-extraction basis as part of the treatment plan, were recruited in this longitudinal study. Orthodontic study models were constructed at baseline and at 6- weeks after orthodontic treatment commenced. Full fixed orthodontic appliances with initial 0.014” Nickel Titanium archwire placed. The amount of crowding was measured, before and after initial alignment with an electronic digital caliper (Max-Cal, Japan Micrometer Ltd, Tokyo, Japan) with an accuracy of up to 0.01mm. Unstimulated morning saliva sample were collected at all visits, after at least an 8-hour period of fasting and no-toothbrushing. After centrifugation (4000x g;10min), the samples were stored at -25C and tested using Leptin Abnova LEP Human ELISA kit (KA3080) which was subsequently analyzed. Subjects’ periodontal health status was also monitored throughout the study. Ethical approval (ID IREC 262) was received on 7th April 2014 from International Islamic University Malaysia Research Ethics Committee (IREC). Results: Leptin concentration in saliva was significantly decreased in a time-dependant manner (t(9)=8.60, p<0.001), from before orthodontic treatment (7016.45± 425.15 pg/mL) and 6 weeks after bond-up (4901.92±  238.64 pg/mL). Conclusion: Leptin concentration in saliva is decreased during orthodontic tooth movement in initial alignment stage.


2015 ◽  
Vol 5 ◽  
pp. 138-143 ◽  
Author(s):  
Harshal N. Suryavanshi ◽  
Vaishali R. Das ◽  
Aashish Deshmukh ◽  
Raj Rai ◽  
Mena Vora

Background and Objectives The average orthodontic treatment time for extraction therapy is 31 months. One of the main disadvantages of orthodontic treatment is time. Alveolar corticotomies have been used in conjunction with orthodontics to reduce the treatment time by increasing the rate of tooth movement. Concerns about the possible risks of corticotomy procedure have led to the modification of this technique. Germeç et al. reported a case treated by their modified corticotomy technique and noted reduced treatment time without any adverse effects on the periodontium and the vitality of teeth with their new conservative corticotomy technique. This study was undertaken to clinically evaluate the efficacy of the aforesaid technique. Materials and Methods A split-mouth study design was carried out to compare the rate of maxillary canine movement with and without modified corticotomy facilitated orthodontic treatment in 10 patients requiring maxillary first premolar extractions. The modified corticotomy procedure was performed on the maxillary arch unilaterally. The upper arch was immediately activated bilaterally after surgical procedure using equal orthodontic forces for retraction of the maxillary canines. The amount of tooth movement was recorded at an interval of every month till the completion of canine retraction. The rate of canine movement on experimental and control site was compared. The patients were followed for 6 months to check the occurrence of undesired effects such as root resorption, periodontal damage and loss of vitality of teeth on the experimental side. Results Higher mean velocity was observed in canines with modified corticotomy facilitated retraction compared to conventionally retracted canines; with the difference in mean velocity between the two groups was found to be clinically significant as well as statistically significant (P < 0.001). Interpretation and Conclusion The results suggested that modified corticotomy technique serves as an effective and safe way to accelerate orthodontic tooth movement, without adversely affecting the periodontium, root resorption, and the vitality of the teeth, as concluded by clinical and radiographic examination.


2019 ◽  
Vol 42 (2) ◽  
pp. 211-221 ◽  
Author(s):  
Mostafa Shahabee ◽  
Hooman Shafaee ◽  
Mostafa Abtahi ◽  
Abdolrasoul Rangrazi ◽  
Erfan Bardideh

Abstract Background The micro-osteoperforation can be used to increase the rate of tooth movement, simplify complex orthodontic movements, and also help adjust the anchorage but there are conflicting reports on the effectiveness and adverse effects of this intervention. Objectives The aim of our systematic review and meta-analysis was to evaluate the effects of micro-osteoperforation on the rate of tooth movement in patients undergoing orthodontic treatment. Search methods A comprehensive search of MEDLINE, ISI web of science, EMBASE, Scopus, and CENTRAL online databases for studies measuring the effects of micro-osteoperforation on the rate of orthodontic tooth movement from inception to February 2019 was performed. Selection criteria Based on the PICO model, human studies which evaluated the effects of MOP on the rate of tooth movement in patients undergoing orthodontic treatment were selected for this review. Data collection and analysis The relevant data from the eligible studies were extracted using piloted custom extraction forms. The data were combined and analysed using inverse-variance random-effect meta-analysis and the mean difference was used for comparing the outcome measures. Results Six randomized clinical trials were finally included in this meta-analysis. The rate of canine retraction per month was significantly higher in the MOP group [mean difference (MD) = 0.45 mm, 95% CI = 0.17–0.74]. These results were similar with regard to different malocclusions, the jaw on which it was performed, and MOP methods. The patients did not report any significant differences in terms of pain severity levels after MOP. With regard to the adverse effects, one study reported higher amounts of root resorption among patients undergoing MOP. Conclusions The rate of tooth movement was increased after performing MOP but in at least one study higher root resorption was observed. Therefore, the use of MOP can be recommended after weighing the benefits and disadvantages this intervention can bring for each patient. Registration The protocol for this review was registered via crd.york.ac.uk/prospero with the ID CRD42019115499.


2021 ◽  
Vol 3 (32) ◽  
pp. 36-51
Author(s):  
Miral Agrawal ◽  
◽  
Shefali Sharma ◽  
Parmeshwari Rathod ◽  
◽  
...  

A high number of adult patients are undertaking orthodontic treatment now because of the newer methods, technology, and innovations available in the market. Orthodontic profession is continually looking for new ways to perform treatment effectively for such patients, as there are many differences in the biology, motivation, and treatment objectives between adults and children. Aligner therapy and mini-implants are some of the ways of managing orthodontic treatment for adult patients. Treatment time is a concern for adult patients and methods to accelerate the orthodontic tooth movement have been a focus in the orthodontic field. Periodontal accelerated osteogenic orthodontics (PAOO) is a surgical procedure that is performed with a combination of alveolar corticotomy, bone grafting, followed by orthodontic treatment. This procedure uses the principle of regional acceleratory phenomenon (RAP). Another procedure commonly used for accelerated orthodontic tooth movement is osteoperforations. This is a minimally invasive procedure, which does not include a flap surgery. The purpose of this article is to describe the differences between adult and children periodontal tissues, the use of different appliances for adult treatment, how orthodontic treatment has been modified for adult patients, and the detailed explanation of procedures for accelerating orthodontic tooth movement such as PAOO and osteoperforations and the potential complications


2018 ◽  
Vol 21 (4) ◽  
pp. 507
Author(s):  
A. Mezari ◽  
F. Si Ahmed

The purpose of this study was to evaluate the efficacy of alveolar corticotomy on orthodontic tooth movement when retracting upper canines compared with the conventionnal treatment. The sample consisted of 30 patients with a mean age of 21 ± 2 years requiring the therapeutic extraction of the maxillary first premolars, with subsequent retraction of the maxillary canines. The subjects were divided into two groups, one receiving orthodontic treatment assisted corticotomy (experimental group) and the other conventional treatment (control group). The velocity of the retraction of the upper canine was evaluated by measuring the distance between the canine and second premolar on each side of the mouth for both groups at 2 months, and 4 months after canine retraction. Results: the velocity of canine was significantly higher on the experimental group than the control group by two times during the first two months after canine retraction. This rate declined to 1.25 times higher after four months. Conclusion: alveolar corticotomy increased orthodontic tooth movement when retracting upper canines.


2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Ainuddin Yushar Yusof ◽  
Rohaya Megat Abdul Wahab ◽  
Shahrul Hisham Zainal Ariffin ◽  
Sahidan Senafi ◽  
Maryati Abdul Rahman

Introduction: Orthodontic tooth movement is a complex process involving tooth and periodontal tissue, which release enzymes and biomarkers. The aim of this study was to investigate enzymes activities of salivary fluid during orthodontic treatment. Materials and Methods: A group of nineteen healthy subject (mean age 21.5 years) with Class II/1 malocclusion who required extraction of maxillary first premolar were recruited. Saliva samples were collected from these 19 patients that underwent canine traction using fixed appliances. Enzymes activities were measured before placement of fixed appliances (basal activity) followed with immediately before and weekly canine retraction for five weeks. The specific Lactate Dehydrogenase (LDH), Aspartate Aminotransferase (AST), Tartrate Resistance Acid Phosphatase (TRAP) and Alkaline Phosphatase (ALP) activities in saliva sample were analyzed using spectrophotometer (405nm). Result: No statistical significant (p> 0.05) difference was noted in LDH activity between basal activity and during canine retraction period. AST showed higher activity compared to basal activity from week 0 to week 1 with statistically significant increased (p<0.05) found in week 1. ALP showed significantly higher enzyme activity compared to basal activity from week 1 to 5, with the peak level at week 5. While TRAP showed significant increase in enzyme activity compared to basal activity only at week 2 after canine retraction. Conclusion(s):  Orthodontic tooth movement can be monitored through the expression of AST, TRAP and ALP activity in saliva. Saliva LDH cannot be used as a biomarker in monitoring tooth movement.


2015 ◽  
Vol 27 (3) ◽  
Author(s):  
Elih E.

Orthodontic treatment results are potentially unstable that has a tendency to return to the former position. This is the so called relapses and therefore retention is necessary because the gingival and periodontal tissues are affected by orthodontic tooth movement and required time for reorganization when the appliances are removed. Retention is the prolonged dental detention that is done at the end of an orthodontic treatment with use of appliances designed for dental stabilization. The purpose of this paper is to explain the cause of relapse and a wide range to prevent relapse. The method used is based on literature. The conclusion is stabilizing treatment results with the retention procedure is an important part in orthodontic treatment. The patient must be given information about the implications of relapse and how to use the retainer, so that the patient can take responsibility for retention phase of treatment.


2021 ◽  
pp. 002203452110199
Author(s):  
Y. Xie ◽  
Q. Tang ◽  
S. Yu ◽  
W. Zheng ◽  
G. Chen ◽  
...  

Orthodontic tooth movement (OTM) depends on periodontal ligament cells (PDLCs) sensing biomechanical stimuli and subsequently releasing signals to initiate alveolar bone remodeling. However, the mechanisms by which PDLCs sense biomechanical stimuli and affect osteoclastic activities are still unclear. This study demonstrates that the core circadian protein aryl hydrocarbon receptor nuclear translocator–like protein 1 (BMAL1) in PDLCs is highly involved in sensing and delivering biomechanical signals. Orthodontic force upregulates BMAL1 expression in periodontal tissues and cultured PDLCs in manners dependent on ERK (extracellular signal–regulated kinase) and AP1 (activator protein 1). Increased BMAL1 expression can enhance secretion of CCL2 (C-C motif chemokine 2) and RANKL (receptor activator of nuclear factor–κB ligand) in PDLCs, which subsequently promotes the recruitment of monocytes that differentiate into osteoclasts. The mechanistic delineation clarifies that AP1 induced by orthodontic force can directly interact with the BMAL1 promoter and activate gene transcription in PDLCs. Localized administration of the ERK phosphorylation inhibitor U0126 or the BMAL1 inhibitor GSK4112 suppressed ERK/AP1/BMAL1 signaling. These treatments dramatically reduced osteoclastic activity in the compression side of a rat orthodontic model, and the OTM rate was almost nonexistent. In summary, our results suggest that force-induced expression of BMAL1 in PDLCs is closely involved in controlling osteoclastic activities during OTM and plays a vital role in alveolar bone remodeling. It could be a useful therapeutic target for accelerating the OTM rate and controlling pathologic bone-remodeling activities.


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