Martina Ferrillo;Dario Calafiore;Lorenzo Lippi;Francesco Agostini;Mario Migliario;Marco Invernizzi;Amerigo Giudice;Alessandro de Sire
대한치과교정학회지
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제54권1호
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pp.26-47
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2024
Objective: This systematic review aimed to evaluate the correlation between vitamin D levels and the rate of tooth movement, external apical root resorption, bone biomarker expression, and bone remodeling. Methods: Three databases (PubMed, Scopus, and Web of Science) were systematically searched from inception until 14th March 2023 to identify studies investigating the correlation between orthodontic tooth movement and vitamin D in animals and humans. The quality assessment was made in accordance with the Joanna Briggs Institute Critical Appraisal Checklist. Results: Overall, 519 records were identified, and 19 were selected for the qualitative synthesis. Eleven studies investigated the effect of local administration (injections in the periodontal ligament, to the gingiva distal to the teeth, or submucosae palatal area) and systemic administration (oral supplementation) of vitamin D on tooth movement, external apical root movement, pro-inflammatory cytokines, and bone remodeling factors. The remaining eight studies investigated the correlation between serum vitamin D levels and salivary vitamin D levels on bone turnover markers and tooth movement. Conclusions: The findings of this systematic review support that vitamin D3 local injections might increase the rate of tooth movement via the receptor activator of the nuclear factor-kB/osteoprotegerin axis. However, the non-uniform study designs and the different protocols and outcome methods make it challenging to draw reliable conclusions.
It is difficult to perform orthodontic treatment for cleft lip and palate patient. Although there are many orthodontic appliances to expand narrowed maxillary arch, results are rarely successful and the possibility of relapse is increased due to severe scars. Self-ligating bracket, recently used in orthodontic treatment, suggests solution of crowding by expansion of dental arches. Light and continuous force could apply for orthodontic movement due to characteristic low friction of self ligating bracket, which gives expansion force until dentition reaches its new equilibrium position and it can be expressed as spontaneous lateral expansion with heavy labial tension. This kind of expansion force is thought to be a possibility of expanding the constricted maxillary arch of cleft lip and palate patient. Repositioning of the maxilla by Le Fort I osteotomy in case of severe maxillary deficiency, increases the possibility of relapse because of limitation in anterior movement and adaptation of soft tissue. In these cases, distraction osteogenesis(DO) can be applied for stable result. We report a case of cleft lip and palate patient with narrowed maxillary arch and maxillary deficiency using self ligating bracket and DO.
Most adults, unlike growing children, have some periodontal problems which can influence the outcome of the orthodontic treatment. In cases where periodontal disease progression resulted in marked reduction of periodontium, orthodontic treatment could result in the worsening of the periodontal conditions, and therefore orthodontic treatment planning in such adult patients requires special considerations for the periodontal problems. This study investigates the effects of horizontal orthodontic tooth movement on the changes in the mesial, distal and furcation areas of the disease affected periodontium of adult dogs with advanced bone loss. Six adult dogs with healthy periodontium were selected, and mandibular 2nd premolars were extracted. In the mandibular 3rd premolars, angular bony defects in the mesial and distal sides, and horizontal bony defects in the furcation areas were created. Those that received the flap operation and plaque control were designated as the control, those that had horizontal tooth movement without plaque control after the flap operation as Experimental group I, those that had horizontal tooth movement under plaque control without the flap operation as Experimental group II, and those that had horizontal tooth movement under plaque control after the flap operation as Experimental group III. The control group was sacrificed 2 months postoperatively, and the experimental groups were sacrificed 5 months after the initiation of tooth movement. Specimens were histologically analyzed under light microscope. The results were as follows; 1. After the horizontal tooth movements, Experimental group I and II showed angular bony defects in the mesial sides of the roots and the distal side of the furcation areas, which correspond to the pressure sides. 2. After the horizontal tooth movements, Experimental group I and II showed decreased level of alveolar bone crest in the distal sides of the roots, which correspond to the tension sides. 3. Long junctional epithelium in the control group has not been replaced by periodontal connective tissue after the horizontal tooth movements. 4. Limited formation of new bone was observed in the angular bony defects in the mesial and distal aspects of the roots in the control group. 5. Inflammatory cell infiltration in the connective tissue was most severe in the Experimental group I, followed by Experimental group II, III, and the control group in that order. These results seem to indicate that plaque control was the most influencing factor in the alteration of the periodontal tissue after the horizontal tooth movements in the periodontal tissue with alveolar bone defects.
Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.
We tend to consider only static occlusion such as molar relationship, canine key, and interdigitation at finishing stage. Of course, this static occlusion is important for post-orthodontic stability. But we should remember that mandible is always on the move during its various functions. If no pressure or too much pressure is put on during its functions, untoward tooth movement could occur. And tooth mobility, periodontitis, wear facet, bruxism, and far worse temporomandibular disorder could occur. After many studies have been done on what is a desirable occlusal scheme to strengthen post-orthodontic stability, today, "mutually protective occlusion" is recommended. If an orthodontist does not have understanding about this occlusal scheme during orthodontic treatment, the following conditions will be resulted after orthodontic treatment. I. Centric discrepancy 1. centric prematurity 2. sunday bite 3. molar fulcrum II. Eccentric discrepancy 1. posterior interference 2. anterior interference If we have deep understanding about these discrepancies that can happen after orthodontic treatment and their causes, corrections, and especially preventions against them, post-orthodontic stability could be strengthened and further temporomandibular disorder could be prevented.
Non-steroidal anti-inflammatory agents are used to relieve pain and to reduce swelling in dental clinics. This experiment was performed to study the effect of non-steroidal anti-inflammatory agents in Sprague-Dawley rats on orthodontic tooth movement. Thirty rats were used and divided six groups of five rats each. The first group, administered saline and no orthodontic force, served as a normal group. The second group, administered saline and applied experimental force, was control group. The other four groups were administered Aspirin, Pontal, Tyrenol and Indomethacin each, and applied experimental orthodontic force by 1/4 inch elastic, inserted into the interproximal space between maxillary first and second molar in rats. All experimental rats were sacrificed after three days, and the specimens were sectioned horizontally five times serially, and counted the number of osteoclasts appeared at the compressed surface of interradicular bone on first buccal root of first molar on light microscope. The obtained results were as follows: 1. The number of osteoclast on the compressed surface of the interradicular bone on first buccal root of the first molar in the four non-steroidal anti-inflammatory agents groups decreased in contrast to control group. 2. In non-steroidal anti-inflammatory agents group, the number of osteoclast in Indomethacin group was least among the all non-steroidal anti-inflammatory agents groups. From the above results, it was believed that the non-steroidal anti-inflammatory agents may have the inhibitory effect of tooth movement during orthodontic treatment.
Tooth movement by orthodontic force is based upon alveolar bone resorption at compression site and bone formation at tension site of tooth. The function of cyclic AMP is to participate not only in initial action of bone cells by mechanical forces but also in the continuous cellular response leading to bone remodeling. This experiment was performed to clarify the role of cyclic AMP in bone remodeling by mechanical forces. The orthodontic forces of about 80 gm and 100 gm were applied to the right canines of maxillary and mandibular bone, respectively, in cats, treated for periods of time ranging from one hour to 28 days. Alveolar bones were obtained from compression and tension sites surrounding tipping maxillary and mandibular canines as well as from contralateral control sites. The samples were extracted, boiled and homogenized, and the supernatants were assayed for cyclic AMP by a radioimmunoassay method. The results were as follows: 1. The orthodontic movement of canines was increased to the end of experimental period and the action of orthodontic forces on tooth movement was more effective in maxillary canine. 2. The cyclic AMP levels of alveolar bones in compression and tension sites initially decreased, then increased and remained elevated to the end of experiment. The differences of the cyclic AMP levels between treated sites and non-treated sites were gradually increased. 3. The cyclic AMP levels in treated sites of mandibular alveolar bone was higher than that of maxillary alveolar bone.
The purpose of this study was to evaluate the effect of orthodontic force on periodontal cellular activity by immunoperoxidase stain of epidermal growth factor, one of the tissue hormone. And supplementarily, to investigate of the changes of periodontal structures, periodontium was stained by H-E, Masson's Trichrome, P. A. S. stain after orthodontic force application. The experimental animals were four young adult dogs of average 8 month old. The fixed orthodontic appliance was cemented on mandibular right 4th premolar and 1st molar of each animal as experimental site. Mandibular left 4th premolar area of the same animal was used as control. The appliance consist of two silver crown soldered with 0.030' tube, $0.018\times0.022'$ S.S. sectional arch wire, and 0.009' open coil spring for manifestating of orthodontic force for bodily tooth movement of mandibular 4th premolar toward mesial direction. Experimental group was sacrificed at 1, 2, 3, 5 weeks from beginning of the experiment, and was investigated immunohistochemically and bistochemically by several staining methods. Findings were as follows: 1. The degree of EGF staining in control group was highest in epithelium of periodontium, and osteoclasts, osteoblasts and fibroblasts around the capillary were stained at higher level in periodontium. Generally, control group shows positive distribution of EGF all around the periodontal area. 2. The degree of EGF staining in control and 5 week group were similar, and did not show the significant different level between tension and pressure side. 3. All of 1, 2, 3 week group showed the same staining degree and distribution of EGF, and the tension side was more positive reaction of EGF stain than the pressure side. 4. The features of collagen fiber and periodontal fiber arrangement observed by H-E, Masson's Trichrome and P. A. S. stain revealed that oblique periodontal fibers were strectched in tension side, compressed in pressure side of all experimental group. Some fiber group in pressure side of 5 week group recovered the regular arrangement along the capillaries.
Objective: The purpose of this study was to clarify the effects of continuous force application for extrusive tipping movement and occlusal interference on periapical root resorption in the rat mandibular first molar. Methods: We constructed an appliance comprising a titanium screw implant with a cobalt-chromium post as the anchorage unit and a nickel-titanium closed coil spring (50 cN) as the active unit. Force was applied on the mandibular left first molar of rats for 8 (n = 10) and 15 days (n = 10; experimental groups), with the tooth in occlusion. Five rats were included as a non-treated control group to examine the body effect of the appliance. Active root resorption lacunae, identified using tartrate-resistant acid phosphatase, were evaluated in terms of the length, depth, and area. Results: The rat mandibular first molars were mesially tipped and extruded in the occlusal direction. This mesio-occlusal tipping movement and occlusion resulted in the formation of a compression zone and active root resorption lacunae in the distoapical third of the distal roots. However, there was no significant difference in the amount of root resorption between the two experimental groups. The control group did not exhibit any active root resorption lacunae. Conclusions: Periapical root resorption was induced by continuous extrusive tipping force and occlusal interference in rat mandibular molars. These data suggest that we orthodontists had better take care not to induce occlusal interference during our orthodontic treatment.
Purpose: Surgical techniques in orthodontics have received widespread attention in recent years. Meanwhile, biomaterials with high molecular content have been introduced, such as platelet concentrates (PCs), which may accelerate orthodontic tooth movement (OTM) and reduce periodontal damage. The present systematic review aimed to answer the following PICO question: "In patients in whom orthodontic surgical techniques are performed (P), what is the effectiveness of using PCs over the surgical site (I) when compared to not placing PCs (C) to achieve faster tooth movement (O)?" Methods: A search was performed in 6 databases. The criteria employed were those described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses declaration. The present review included studies with a control group that provided information about the influence of PCs on the rate of OTM. Results: The electronic search identified 10 studies that met the established criteria. Conclusions: The included studies were very diverse, making it difficult to draw convincing conclusions. However, a tendency was observed for OTM to be accelerated when PCs were used as an adjuvant for canine distalization after premolar extraction when distalization was started in the same session. Likewise, studies seem to indicate an association between PC injection and the amount of canine retraction. However, it is not possible to affirm that the use of PCs in corticotomy shortens the overall treatment time, as this question has not been studied adequately.
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