scholarly journals Uncontrolled diabetes mellitus: a current understanding of the mechanisms underlying the disease that affect orthodontic tooth movement

Author(s):  
Daniela Gomides SAMARTINI ◽  
Manuela Ortega Marques RODRIGUES ◽  
Carina de Sousa SANTOS

ABSTRACT With improvements in dental aesthetic requirements an increasing number of adults are seeking orthodontic treatment that, along with current lifestyle and eating habits of the adult population, makes orthodontists more likely to encounter patients with metabolic disorders such as diabetes mellitus. Speculated that the diabetic patient during orthodontic treatment may not experience a physiological healing process as a healthy patient. Therefore, the objective of this work is to present a current and contextualized review of the mechanisms by which uncontrolled diabetes mellitus impacts on bone remodeling and orthodontic tooth movement during the application of orthodontic forces. The following databases were searched MEDLINE (via PubMed), Scopus, Web of Science, SciELO, LILACS and open grey with these MeSH “bone remodeling”, “diabetes mellitus”, “orthodontic” and “tooth movement”. Five articles remained after search strategy and were analyzed. In sum, no clinical studies were found, the evidence was limited to animal studies (rats). The results suggest that there are differences in bone remodeling and tooth movement during the application of orthodontic forces in animals with diabetes mellitus when compared to healthy animals, especially when the disease is associated with periodontal disease. However, the results are still controversial and may be due to different study protocols.

2021 ◽  
Vol 22 (5) ◽  
pp. 2388
Author(s):  
Masaru Yamaguchi ◽  
Shinichi Fukasawa

The aim of this paper is to provide a review on the role of inflammation in orthodontically induced inflammatory root resorption (OIIRR) and accelerating orthodontic tooth movement (AOTM) in orthodontic treatment. Orthodontic tooth movement (OTM) is stimulated by remodeling of the periodontal ligament (PDL) and alveolar bone. These remodeling activities and tooth displacement are involved in the occurrence of an inflammatory process in the periodontium, in response to orthodontic forces. Inflammatory mediators such as prostaglandins (PGs), interleukins (Ils; IL-1, -6, -17), the tumor necrosis factor (TNF)-α superfamily, and receptor activator of nuclear factor (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) are increased in the PDL during OTM. OIIRR is one of the accidental symptoms, and inflammatory mediators have been detected in resorbed roots, PDL, and alveolar bone exposed to heavy orthodontic force. Therefore, these inflammatory mediators are involved with the occurrence of OIIRR during orthodontic tooth movement. On the contrary, regional accelerating phenomenon (RAP) occurs after fractures and surgery such as osteotomies or bone grafting, and bone healing is accelerated by increasing osteoclasts and osteoblasts. Recently, tooth movement after surgical procedures such as corticotomy, corticision, piezocision, and micro-osteoperforation might be accelerated by RAP, which increases the bone metabolism. Therefore, inflammation may be involved in accelerated OTM (AOTM). The knowledge of inflammation during orthodontic treatment could be used in preventing OIIRR and AOTM.


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
A. Niklas ◽  
P. Proff ◽  
M. Gosau ◽  
P. Römer

Orthodontic forces are known to have various effects on the alveolar process, such as cell deformation, inflammation, and circulatory disturbances. Each of these conditions affecting cell differentiation, cell repair, and cell migration, is driven by numerous molecular and inflammatory mediators. As a result, bone remodeling is induced, facilitating orthodontic tooth movement. However, orthodontic forces not only have cellular effects but also induce vascular changes. Orthodontic forces are known to occlude periodontal ligament vessels on the pressure side of the dental root, decreasing the blood perfusion of the tissue. This condition is accompanied by hypoxia, which is known to either affect cell proliferation or induce apoptosis, depending on the oxygen gradient. Because upregulated tissue proliferation rates are often accompanied by angiogenesis, hypoxia may be assumed to fundamentally contribute to bone remodeling processes during orthodontic 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.


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.


2021 ◽  
Vol 11 (9) ◽  
pp. 3824
Author(s):  
Ioana-Andreea Sioustis ◽  
Mihai Axinte ◽  
Marius Prelipceanu ◽  
Alexandra Martu ◽  
Diana-Cristala Kappenberg-Nitescu ◽  
...  

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.


2009 ◽  
Vol 79 (6) ◽  
pp. 1126-1132 ◽  
Author(s):  
Xiulin Yan ◽  
Jiang Chen ◽  
Yuquan Hao ◽  
Yan Wang ◽  
Li Zhu

Abstract Objective: To investigate the changes of caspase-1 in orthodontic tooth movement and to determine whether the changes are phase-specific. Materials and Methods: Eighty Wistar rats were included in this study. Sentalloy closed-coil springs were placed to induce a mesial traction force on the lower right first molar. The animals were killed after 1, 3, 7, and 14 days (n = 20 at each time point). The mandibles of 10 rats were sampled for histomorphometric analysis and immunohistochemical assay, and the periodontal tissues of 10 other rats were sampled for detecting caspase-1 mRNA and protein by real-time RT-PCR and by Western blotting, respectively. Results: The inflammatory reaction was evident in paraffin sections with hematoxylin-eosin staining. The immunohistochemical assay showed that orthodontic forces significantly increased the number of caspase-1-positive cells in the periodontal ligament (PDL). Mechanical force triggered an increase of caspase-1 mRNA in periodontal tissues. The expression of caspase-1 mRNA increased from day 1, reached the peak on day 3, and then decreased. The results of Western blotting indicated that the levels of both procaspase-1 and P20 subunit significantly increased after the application of orthodontic forces, compared with those in controls (P < .05). Conclusion: Caspase-1 level increases during orthodontic tooth movement and changes with different phases, which might play a significant role in orthodontic tooth movement.


2018 ◽  
Vol 7 (2) ◽  
pp. 47-51
Author(s):  
Neeta Aryal ◽  
Mao Jing

Introduction: Root resorption is the loss of apical root tissue leading to the shortness of root which is often evident in orthodontic tooth movement. Proper management during orthodontic treatment however can minimize this undesirable outcome. The present article attempts to review the etiology of root resorption, methods of diagnosis, and strategies for prevention.Materials & Method: A scoping review was done with the purpose to carry out the narrative integration of the relevant evidences on root resorption and orthodontic treatment from the published literatures. The resulting papers were studied and reviewed thoroughly for the key explanation of root resorption in orthodontic patients. A total of 41 published research articles were reviewed.Discussion: According to the literatures root resorption is common iatrogenic outcome in orthodontic treatment. Biological, mechanical, and combined biological and mechanical factors result in external root resorption. Though most clinicians diagnose root resorption by conventional radiography, researches have clearly shown that CBCT is the promising tool. The clinicians need to counsel orthodontic patients and their parents that the root resorption might be a potential consequence of the treatment lasting for long time. In case of severity; it is essential to reassess the patient and minimize the underlying cause. It is necessary to understand the role of orthodontist in preventing root resorption


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.


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