Efficacy of Papain-Arginine Gel on Gingivitis Treatment Caused by Orthodontic Appliances

Orthodontic appliances can be linked to a lack of proper oral hygiene which is commonly associated with gingivitis incidence. Gingivitis treatment is required to prevent further periodontal diseases such as periodontitis, pocket formation, tooth luxation, and tooth loss. Papain is known for its anti-inflammatory, antibacterial and antioxidant effects, while arginine is known for its capability to inhibit biofilm formation and interfering plaque stability. This study aimed to demonstrate the effect of papain-arginine gel on gingivitis caused by orthodontic appliances. The gel was prepared from CMC-Na as the polymer. The papain and arginine powder was successfully dissolved homogenously into the CMC-Na in aquadest 50 mL at 25°C. Papain-arginine gel showed good stability in room temperature with pH 7. Therefore, the gel is suitable for oral application. Twenty-seven adult Sprague dawleyrats weighing ± 250–300 g were included in this study. A closing loop was placed in the margin gingiva of animal’s upper incisor to generate orthodontic force and develop reproducible gingivitis. After 7 days of orthodontic tooth movement, animals were randomly divided into three groups; the papain-arginine gel group, the chlorhexidine gel group, and the untreated group. Three rats in every group were conducted clinical observation on its gingival index (GI) and periodontal pocket depths (PPD) before and at 1, 3 and 7 days after treatment. The number of newly-formed capillaries, neutrophils and macrophages proliferation were evaluated using haematoxylin-eosin staining. The clinical response such as increasing GI and decreasing PPD on the treatment did not appear significant difference (P> .05); while the histopathological analysis showed neutrophil and macrophage proliferation were significantly higher andreached its peak on day 3 after papain-arginine and chlorhexidine gel application(P < .05).A considerably larger number of newly-formed capillary formed, and the smaller number of neutrophils and macrophages were noticed significantly at 7 days after papain-arginine and chlorhexidine gel treatment (P> .05). In early gingivitis lesion, gingiva may appear clinically healthy. However, previous studies suggested that inflammatory cells decrease indicates the process of gingivitis healing. Treatment with papain-arginine gel compared to the untreated group significantly diminished the process of inflammation. Hence, it can be concluded that papain-arginine gel was efficient in treating gingivitis caused by orthodontic appliances.

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Effects of salbutamol, montelukast and prednisone on orthodontic tooth movement in rats

Brazilian Dental Science ◽

10.14295/bds.2021.v24i2.2394 ◽

2021 ◽

Vol 24 (2) ◽

Author(s):

Victor Chumpitaz-Cerrate ◽

Lesly Chávez-Rimache ◽

César Franco-Quino ◽

Eliberto Ruiz-Ramirez ◽

Elías Aguirre-Siancas ◽

...

Keyword(s):

Clinical Evaluation ◽

Tooth Movement ◽

Orthodontic Tooth Movement ◽

Study Groups ◽

Preclinical Study ◽

Control Group ◽

Histopathological Analysis ◽

Significant Difference ◽

Interincisal Distance

Objective: To evaluate the effect of salbutamol, montelukast, and prednisone on orthodontic tooth movement in rats. Material and Methods: In vivo experimental preclinical study. The sample consisted of 48 rats randomly distributed in four study groups. Group A was given saline solution; to group B, salbutamol 4 mg/Kg; to group C, montelukast 2.5 mg/Kg and to group D, prednisone 2.5 mg/Kg. All were fitted with orthodontic devices and the medications were administered intraperitoneally every 12 hours for 5 days. The clinical evaluation (variation in the interincisal distance) was performed at one, three, five, and seven days and the histopathological analysis (cell count) at five and seven days. Results: In the clinical evaluation of the variation in the interincisal distance, a significant difference was found in all the evaluations (p <0.05). It was found that the salbutamol group presented higher variation values in the interincisal distance on all the days evaluated. In the histopathological analysis at five and seven days, it was found that the osteoblast and osteocyte count was significantly higher in the salbutamol group compared to the other groups (p ><0.05). However, in the subgroup analysis, it was found that there was no significant difference in the osteoblast and osteocyte count between the prednisone, montelukast, and control group (p>0.05). Conclusion: The administration of salbutamol increased the magnitude of orthodontic tooth movement; nonetheless, the administration of montelukast and prednisone did not modify the magnitude of orthodontic tooth movement in rats. Keywords Albuterol; Montelukast; Prednisone; Rats; Tooth movement.

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Saliva Leptin Levels in Tooth Movement during Initial Stage of Orthodontic Alignment: A Pilot Study

Brazilian Journal of Oral Sciences ◽

10.20396/bjos.v16i0.8651060 ◽

2017 ◽

Vol 16 ◽

pp. 1-8

Author(s):

Noraini Abu Bakar ◽

Wisam Kamil ◽

Lina Al Bayati ◽

Basma Ezzat Mustafa

Keyword(s):

Pilot Study ◽

Mechanical Stress ◽

Orthodontic Treatment ◽

Tooth Movement ◽

Orthodontic Tooth Movement ◽

Biologically Active ◽

Orthodontic Appliances ◽

Initial Alignment ◽

Periodontal Tissues ◽

Before And After

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.

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The effect of autologous leukocyte platelet rich fibrin on the rate of orthodontic tooth movement: A prospective randomized clinical trial

European Journal of Dentistry ◽

10.4103/ejd.ejd_424_17 ◽

2018 ◽

Vol 12 (03) ◽

pp. 350-357 ◽

Cited By ~ 4

Author(s):

Azita Tehranchi ◽

Hossein Behnia ◽

Fereydoun Pourdanesh ◽

Parsa Behnia ◽

Nelson Pinto ◽

...

Keyword(s):

Clinical Trial ◽

Tooth Movement ◽

Random Effect ◽

Random Effect Model ◽

Orthodontic Tooth Movement ◽

Control Group ◽

Extraction Socket ◽

Effect Model ◽

Significant Difference ◽

And Control

ABSTRACT Objective: The aim of this study was to evaluate the effect of LPRF, placed in extraction sockets, on orthodontic tooth movement (OTM). Materials and Methods: Thirty extraction sockets from eight patients (five males, three females, with a mean age of 17.37 years; range 12–25 years) requiring extraction of first premolars based on their orthodontic treatment plan participated in this split-mouth clinical trial. In one randomly selected quadrant of each jaw, the extraction socket was preserved as the experimental group by immediate placement of LPRF in the extraction socket. The other quadrant served as the control group for secondary healing. Immediately, the teeth adjacent to the defects were pulled together by a NiTi closed-coil spring with constant force. A piece of 0.016 × 0.022-inch stainless steel wire was used as the main arch wire. The amount of OTM was measured on the study casts at eight time points with 2-week intervals for 3 months. Analysis of random effect model was performed for the purpose of comparison between the experimental and control groups. Results: According to the random effect model, a statistically significant difference was found between the experimental and control group in rate of OTM (P = 0.006). Conclusion: According to the results, application of LPRF, as an interdisciplinary approach combining orthodontics and surgery, may accelerate OTM, particularly in extraction cases.

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Effect of platelet-rich plasma on the rate of orthodontic tooth movement:

The Angle Orthodontist ◽

10.2319/072119-483.1 ◽

2020 ◽

Vol 90 (3) ◽

pp. 354-361 ◽

Cited By ~ 1

Author(s):

Ahmed El-Timamy ◽

Fouad El Sharaby ◽

Faten Eid ◽

Amr El Dakroury ◽

Yehya Mostafa ◽

...

Keyword(s):

Tooth Movement ◽

Platelet Rich Plasma ◽

Orthodontic Tooth Movement ◽

The Other ◽

Positive Potential ◽

Canine Retraction ◽

Steady Rate ◽

Significant Difference ◽

To Receive ◽

Retraction Force

ABSTRACT Objective To investigate the effect of local injection of platelet-rich plasma (PRP) on the rate of orthodontic tooth movement. Materials and Methods Sixteen female patients were randomly allocated in a split-mouth study design to receive PRP injections with CaCl2 activating solution on one side (intervention side) while the other side received CaCl2 injection only (control side). Canine retraction was performed on 0.017 × 0.025-inch stainless steel archwire applying 1.5 N retraction force. PRP and CaCl2 injections were done at 0, 3, and 6 weeks. The duration of the study was 4 months. Data were collected from digitized models. Assessment of pain accompanying the procedure was done using a visual analogue scale. Results The rate of canine retraction was faster on the intervention side in the first 2 months, with a statistically significant difference in the first month (P = .049). On the other hand, the rate was statistically significantly slower on the intervention side in the third month following cessation of PRP injections (P = .02). Pain increased following injections on both sides. Conclusions PRP showed a positive potential to accelerate the rate of tooth movement when injected in the first 2 months. Repeated injections of PRP to maintain a steady rate of accelerated tooth movement warrant further investigation.

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Pain Experience with Micro-osteoperforations during Initial Orthodontic Alignment: A Randomized Clinical Trial.

Journal Of Oral Research ◽

10.17126/joralres.2020.072 ◽

2020 ◽

Vol 9 (4) ◽

pp. 309-318

Author(s):

Azaitun Akma Shahrin ◽

◽

Sarah Haniza Abdul Ghani ◽

Noraina Hafizan Norman ◽

◽

...

Keyword(s):

Clinical Trial ◽

Repeated Measures ◽

Pain Perception ◽

Tooth Movement ◽

Intervention Group ◽

Orthodontic Tooth Movement ◽

Control Group ◽

Initial Alignment ◽

Significant Difference ◽

Fixed Appliances

Objetive: The objective of this clinical trial was to investigate the perception of pain during initial maxillary alignment with an adjunctive procedure of micro-osteoperforations (MOPs) compared to conventional orthodontics. Material and methods: This study design was a single-centre, two-arm parallel prospective randomised clinical trial. Thirty consecutive adult subjects (25 females and 5 males; mean age ± SD, 22.66 ± 3.27 years) with 5-8mm moderate upper labial segment crowding were randomly allocated using block randomisation into intervention and control group. All subjects had first premolar extractions, bonded conventional fixed appliances and 0.014-inch nickel-titanium archwire was placed for initial alignment. The intervention group received a 3-mm deep MOPs procedure under local anaesthesia using a Propel device (PROPEL Ortho Singapore) on the labiogingival aspect between the maxillary incisors. Both groups received a set of 100 mm visual analogue scale to complete over the first week, recording pain at 24 hours, 3 days and 1 week. Data were analysed using repeated-measures analysis of variance (ANOVA). Results: There was a statistically significant difference observed in perceived pain levels between MOPs and the control group on day 1, day 3 and day 7 postoperatively. Pain perception was significantly lower in the intervention group at all time points. Conclusion: Accelerating orthodontic tooth movement with MOPs did not accentuate pain perceived during initial maxillary alignment with fixed appliances.

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

PeerJ ◽

10.7717/peerj.1625 ◽

2016 ◽

Vol 4 ◽

pp. e1625 ◽

Cited By ~ 1

Author(s):

Martina Von Böhl ◽

Yijin Ren ◽

Anne M. Kuijpers-Jagtman ◽

Piotr S. Fudalej ◽

Jaap C. Maltha

Keyword(s):

Dental Pulp ◽

Tooth Movement ◽

Orthodontic Tooth Movement ◽

Inflammatory Cells ◽

Contralateral Side ◽

Pulp Tissue ◽

Adult Rats ◽

Force Application ◽

Age Related ◽

Age Related Changes

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.

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Periodontal Pathogens Invade Gingiva and Aortic Adventitia and Elicit Inflammasome Activation in αvβ6 Integrin-Deficient Mice

Infection and Immunity ◽

10.1128/iai.01077-15 ◽

2015 ◽

Vol 83 (12) ◽

pp. 4582-4593 ◽

Cited By ~ 27

Author(s):

Irina M. Velsko ◽

Sasanka S. Chukkapalli ◽

Mercedes F. Rivera-Kweh ◽

Donghang Zheng ◽

Ikramuddin Aukhil ◽

...

Keyword(s):

Atherosclerotic Plaque ◽

Inflammatory Responses ◽

Periodontal Diseases ◽

Periodontal Pocket ◽

Bacterial Invasion ◽

Inflammasome Activation ◽

Periodontal Pathogens ◽

Content Type ◽

Amyloid A ◽

Significant Difference

The American Heart Association supports an association between periodontal diseases and atherosclerosis but not a causal association. This study explores the use of the integrin β6−/−mouse model to study the causality. We investigated the ability of a polymicrobial consortium ofPorphyromonas gingivalis,Treponema denticola,Tannerella forsythia, andFusobacterium nucleatumto colonize the periodontium and induce local and systemic inflammatory responses. Polymicrobially infectedItgβ6−/−mice demonstrate greater susceptibility to gingival colonization/infection, with severe gingival inflammation, apical migration of the junctional epithelium, periodontal pocket formation, alveolar bone resorption, osteoclast activation, bacterial invasion of the gingiva, a greater propensity for the bacteria to disseminate hematogenously, and a strong splenic T cell cytokine response. Levels of atherosclerosis risk factors, including serum nitric oxide, oxidized low-density lipoprotein, serum amyloid A, and lipid peroxidation, were significantly altered by polybacterial infection, demonstrating an enhanced potential for atherosclerotic plaque progression. Aortic gene expression revealed significant alterations in specific Toll-like receptor (TLR) and nucleotide-binding domain- and leucine-rich-repeat-containing receptor (NLR) pathway genes in response to periodontal bacterial infection. Histomorphometry of the aorta demonstrated larger atherosclerotic plaques inItgβ6−/−mice than in wild-type (WT) mice but no significant difference in atherosclerotic plaque size between mice with polybacterial infection and mice with sham infection. Fluorescencein situhybridization demonstrated active invasion of the aortic adventitial layer byP. gingivalis. Our observations suggest that polybacterial infection elicits distinct aortic TLR and inflammasome signaling and significantly increases local aortic oxidative stress. These results are the first to demonstrate the mechanism of the host aortic inflammatory response induced by polymicrobial infection with well-characterized periodontal pathogens.

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Impact of Obesity on Orthodontic Tooth Movement in Adolescents: A Prospective Clinical Cohort Study

Journal of Dental Research ◽

10.1177/0022034516688448 ◽

2017 ◽

Vol 96 (5) ◽

pp. 547-554 ◽

Cited By ~ 23

Author(s):

H.F. Saloom ◽

S.N. Papageorgiou ◽

G.H. Carpenter ◽

M.T. Cobourne

Keyword(s):

Cohort Study ◽

Tooth Movement ◽

Orthodontic Tooth Movement ◽

Normal Weight ◽

Orthodontic Appliances ◽

Inflammatory Disorder ◽

Obese Patients ◽

Periodontal Tissues ◽

Clinical Cohort ◽

Fixed Orthodontic Appliances

Obesity is a widespread chronic inflammatory disorder characterized by an increased overall disease burden and significant association with periodontitis. The aim of this prospective clinical cohort study was to investigate the effect of obesity on orthodontic tooth movement. Fifty-five adolescent patients (27 males, 28 females) with a mean (SD) age of 15.1 (1.7) years and mean (SD) body mass index (BMI) of 30.2 (3.5) kg/m2 in obese and 19.4 (2.2) kg/m2 in normal-weight groups were followed from start of treatment to completion of tooth alignment with fixed orthodontic appliances. Primary outcome was time taken to complete tooth alignment, while secondary outcomes included rate of tooth movement and change in clinical parameters (plaque/gingival indices, unstimulated whole-mouth salivary flow rate, gingival crevicular fluid biomarkers). Data collection took place at baseline (start of treatment: appliance placement), 1 h and 1 wk following appliance placement, and completion of alignment. Results were analyzed by descriptive statistics followed by generalized estimating equation regression modeling. There were no significant differences between groups in time taken to achieve tooth alignment (mean [SD] 158.7 [75.3] d; P = 0.486). However, at 1 wk, initial tooth displacement was significantly increased in the obese group ( P < 0.001), and after adjusting for confounders, obese patients had a significantly higher rate of tooth movement compared with normal-weight patients (+0.017 mm/d; 95% confidence interval, 0.008–0.025; P < 0.001) over the period of alignment. Explorative analyses indicated that levels of the adipokines leptin and resistin, the inflammatory marker myeloperoxidase (MPO), and the cytokine receptor for nuclear factor kappa-B ligand (RANKL) were significantly different between obese- and normal-weight patients and associated with observed rates of tooth movement. This represents the first prospective data demonstrating a different response in obese patients compared with normal-weight patients during early orthodontic treatment. These differences in the response of periodontal tissues to orthodontic force in the presence of obesity have potential short- and long-term clinical implications.

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Non-invasive evaluation of periodontal ligament stiffness during orthodontic tooth movement

The Angle Orthodontist ◽

10.2319/031918-218.1 ◽

2018 ◽

Vol 89 (2) ◽

pp. 228-234 ◽

Cited By ~ 1

Author(s):

Lindsey Westover ◽

Gary Faulkner ◽

Carlos Flores-Mir ◽

William Hodgetts ◽

Don Raboud

Keyword(s):

Periodontal Ligament ◽

Tooth Movement ◽

Orthodontic Tooth Movement ◽

Orthodontic Appliances ◽

Longitudinal Changes ◽

Non Invasive ◽

Space Closure ◽

Average Maximum ◽

Final Measurement ◽

Pre Treatment

ABSTRACT Objectives: To evaluate the longitudinal changes in periodontal ligament (PDL) stiffness during orthodontic tooth movement using the Advanced System for Implant Stability Testing (ASIST). Materials and Methods: ASIST measurements of maxillary canines that were actively retracted into an extraction space were collected approximately once per month for 12 adolescent female patients. The ASIST Stability Coefficient (ASC) values, which are directly related to PDL stiffness, were determined for each visit to examine longitudinal changes for individual canines as they were exposed to different forces (approximately 80 and 150 g) during retraction. Results: The pattern of longitudinal changes in ASC was similar for both canines (regardless of the two force levels applied) in individual patients and across patients. All patients showed some decrease in ASC, with an average maximum reduction in stiffness of 73.4 ± 7.7%. Some recovery was observed for most patients; however, none of the patients had the PDL stiffness return to the pre-treatment value at the final measurement appointment which was some time close after space closure was completed. On average, the ASC value at the final measured visit was 48.1 ± 12.2% of the initial value. No measurements are available after removal of orthodontic appliances and during retention. Conclusions: The ASIST was able to detect changes in PDL stiffness during orthodontic treatment, providing some insight into the mechanical changes that occur at the tooth root interface.

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Evaluation of Oxidative Stress Biomarkers in Patients with Fixed Orthodontic Appliances

Disease Markers ◽

10.1155/2014/597892 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 12

Author(s):

Sevil Sema Atuğ Özcan ◽

İsmail Ceylan ◽

Erkan Özcan ◽

Nezahat Kurt ◽

İlhan Metin Dağsuyu ◽

...

Keyword(s):

Orthodontic Treatment ◽

Tooth Movement ◽

Gingival Crevicular Fluid ◽

Orthodontic Tooth Movement ◽

Orthodontic Appliances ◽

Oxidative Stress Biomarkers ◽

Necrosis Factor Alpha ◽

Physiological Limits ◽

Fixed Orthodontic Appliances ◽

Materials Used

Aim.The aim of this study was to examine the changes in the levels of interleukine-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), malondialdehyde (MDA), nitric oxide (NO), and 8-hydroxydeoxyguanosine (8-OHdG) in saliva and IL-1β, TNF-α, and NO in gingival crevicular fluid (GCF) samples of patients with fixed orthodontic appliances.Material and Method.The subject population consisted of 50 volunteers who were in need of orthodontic treatment with fixed orthodontic appliances. GCF and saliva samples were obtained from all individuals before treatment, at 1st month of treatment and at 6th month of treatment. Periodontal clinical parameters were measured. Samples were investigated to detect IL-1β, TNF-α, and 8-OHdG levels using ELISA method and NO and MDA levels using spectrophotometric method.Results.Since IL-1βlevel detected in GCF at the 6th month of orthodontic treatment is statistically significant according to baseline (P<0.05), all other biochemical parameters detected both in saliva and in GCF did not show any significant change at any measurement periods.Conclusion.Orthodontic tooth movement and orthodontic materials used in orthodontic treatment do not lead to a change above the physiological limits that is suggestive of oxidative damage in both GCF and saliva.

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