Effect of different interventions on orthodontic tooth movement acceleration:A network meta-analysis

Objective: To explore the effectiveness of various interventions in accelerating tooth movement, a systematic review and net-work meta analysis were used to draw a conclusion. Methods: MEDLINE, EMBASE, Willey Library, EBSCO, Web of Science Databases, and Cochrane Central Register of Controlled Trials databases to identify relevant studies. ADDIS 1.16.6 and Stata 16.0 software were used for NMA. Results: Five thousand five hundred and forty-two articles were searched out. After screening by two independent investigators, forty-seven randomized controlled trials, 1 390 participants, were included in this network meta-analysis. A total of 11 interventions involving Piezocision (Piezo), Photobiomodulation therapy (PBMT), Plate- let-rich plasma(PRP), Electromagnetic field(EF), Low intensity laser therapy(LLLT), Low intensity pulsed ultrasound(LI-PUS), Low-frequency vibrations(LFV), Distraction osteogenesis(DAD), Corticotomy(Corti), Microosteoperforations (MOPS), Traditional orthodontic(OT)were identified and classified into 3 classes including surgical treatment, non-surgical treatment and traditional orthodontic treatment. According to SUCRA probability ranking of the best intervention effect, when orthodontic treatment lasted for 1 month, PBMT (90.6%), Piezo(87.4%) and MOPs(73.6%)were the top three interventions to improve the efficiency of canine tooth movement. When orthodontic treatment lasted for 2 months, Corti (75.7%), Piezo (69.6%) and LFV(58.9%)were the top three interventions for improving the mobility efficiency of canine tooth movement. When orthodontic treatment lasted for 3 months, Cort (73.3%), LLLT(68.4%)and LFV(60.8%)were the top three interventions for improving the mobility efficiency of canine tooth movement. Conclusion: PBMT and Piezo can improve the efficiency of canine tooth movement significantly after 1 month, while Corti and LFV can improve the efficiency of canine tooth movement better after 2 and 3 months.

Low-intensity pulsed ultrasound reduces alveolar bone resorption during orthodontic treatment via Lamin A/C-Yes-associated protein axis in stem cells

BACKGROUND The bone remodeling during orthodontic treatment for malocclusion often requires a long duration of around two to three years,which also may lead to some complications such as alveolar bone resorption or tooth root resorption.Low-intensity pulsed ultrasound(LIPUS),a noninvasive physical therapy,has been shown to promote bone fracture healing.It is also reported that LIPUS could reduce the duration of orthodontic treatment;however,how LIPUS regulates the bone metabolism during the orthodontic treatment process is still unclear.AIM To investigate the effects of LIPUS on bone remodeling in an orthodontic tooth movement(OTM)model and explore the underlying mechanisms.METHODS A rat model of OTM was established,and alveolar bone remodeling and tooth movement rate were evaluated via micro-computed tomography and staining of tissue sections.In vitro,human bone marrow mesenchymal stem cells(hBMSCs)were isolated to detect their osteogenic differentiation potential under compression and LIPUS stimulation by quantitative reverse transcription-polymerase chain reaction,Western blot,alkaline phosphatase(ALP)staining,and Alizarin red staining.The expression of Yes-associated protein(YAP1),the actin cytoskeleton,and the Lamin A/C nucleoskeleton were detected with or without YAP1 small interfering RNA(siRNA)application via immunofluorescence.RESULTS The force treatment inhibited the osteogenic differentiation potential of hBMSCs;moreover,the expression of osteogenesis markers,such as type 1 collagen(COL1),runt-related transcription factor 2,ALP,and osteocalcin(OCN),decreased.LIPUS could rescue the osteogenic differentiation of hBMSCs with increased expression of osteogenic marker inhibited by force.Mechanically,the expression of LaminA/C,F-actin,and YAP1 was downregulated after force treatment,which could be rescued by LIPUS.Moreover,the osteogenic differentiation of hBMSCs increased by LIPUS could be attenuated by YAP siRNA treatment.Consistently,LIPUS increased alveolar bone density and decreased vertical bone absorption in vivo.The decreased expression of COL1,OCN,and YAP1 on the compression side of the alveolar bone was partially rescued by LIPUS.CONCLUSION LIPUS can accelerate tooth movement and reduce alveolar bone resorption by modulating the cytoskeleton-Lamin A/C-YAP axis,which may be a promising strategy to reduce the orthodontic treatment process.

Dynamic Analysis of the Expression of HSP70 during Experimental Tooth Movement in Rats

In this study, the expression of HSP70 during experimental tooth movement was dynamically observed and the relationship between HSP70 and orthodontic periodontal tissue remodeling were observed. The orthodontic appliance was placed between the right maxillary first molar and maxillary central incisors of adult SD rats to establish a rat molar movement model. Immunohistochemistry was performed 1, 3, 5, 7 and 14 day（s） after orthodontic force application to observe the expression and localization of inducible HSP70. The expression of HSP70 was strongly positive in the early stage of the tooth movement, became gradually less positive, and was weakly positive in the restoration stage. There was difference in staining pattern between different parts of PDL during the same period. These results suggest that the expression of HSP70 and difference in staining pattern among different parts of PDL during orthodontic tooth movement in rats may be implicated in stress response and remodeling of periodontal tissue.

Periodontally accelerated osteogenic orthodontics with platelet-rich fibrin in an adult patient with periodontal disease:A case report and review of literature

BACKGROUND In the clinical scenario,adult patients with periodontal diseases and dental malformation,characterized by dental crowding in lower anterior teeth with the thin biotype,often require orthodontic treatment.This case report aimed to evaluate the clinical and radiographic outcomes of periodontally accelerated osteogenic orthodontics(PAOO)combined with autologous platelet-rich fibrin(PRF)in an adult patient with class I malocclusion along with dental crowding,a thin periodontal biotype,and buccal plate deficiency.CASE SUMMARY A 32-year-old female complaining of dental crowding and gingival bleeding was referred to the orthodontic clinic.The patient underwent periodontal risk assessment prior to orthodontic treatment.She was diagnosed with a high risk of gingival recession due to dental crowding,root prominence,loss of buccal plates,and a thin gingival tissue biotype.The treatment regimen included PAOO combined with autologous PRF for alveolar augmentation and interproximal enamel reduction for moderate dental crowding.Clinically,PAOO-assisted orthodontic tooth movement in this case showed enhanced periodontium remodeling.Radiographic outcomes also showed statistically significant improvements(P<0.01)in the mandibular buccal alveolar bone.CONCLUSION This case report suggests the combination of autologous PRF with PAOO to enhance bone augmentation and long-term tissue support in adult orthodontic patients with periodontal disease.

Lithium chloride promotes osteogenesis and suppresses apoptosis during orthodontic tooth movement in osteoporotic model via regulating autophagy

Osteoporosis is a widely distributed disease that may cause complications such as accelerated tooth movement,bone resorption,and tooth loss during orthodontic treatment.Promoting bone formation and reducing bone resorption are strategies for controlling these complications.For several decades,the autophagy inducer lithium chloride(LiCl)has been explored for bipolar.In this study,we investigated the autophagy-promoting effect of LiCl on bone remodeling under osteoporotic conditions during tooth movement.Ovariectomy was used to induce osteoporosis status in vivo.The results showed that LiCl rejuvenated autophagy,decreased apoptosis,and promoted bone formation,thus protecting tooth movement in osteoporotic mice.Furthermore,in vitro experiments showed that LiCl reversed the effects of ovariectomy on bone marrow-derived mesenchymal stem cells(BMSCs)extracted from ovariectomized mice,promoting osteogenesis and suppressing apoptosis by positively regulating autophagy.These findings suggest that LiCl can significantly decrease adverse effects of osteoporosis on bone remodeling,and that it has great potential significance in the field of bone formation during tooth movement in osteoporosis patients.

Biocompatible reduced graphene oxide stimulated BMSCs induce acceleration of bone remodeling and orthodontic tooth movement through promotion on osteoclastogenesis and angiogenesis

We has synthesized the biocompatible gelatin reduced graphene oxide(GOG)in previous research,and in this study we would further evaluate its effects on bone remodeling in the aspects of osteoclastogenesis and angiogenesis so as to verify its impact on accelerating orthodontic tooth movement.The mouse orthodontic tooth movement(OTM)model tests in vivo showed that the tooth movement was accelerated in the GOG local injection group with more osteoclastic bone resorption and neovascularization compared with the PBS injection group.The analysis on the degradation of GOG in bone marrow stromal stem cells(BMSCs)illustrated its good biocompatibility in vitro and the accumulation of GOG in spleen after local injection of GOG around the teeth in OTM model in vivo also didn’t influence the survival and life of animals.The co-culture of BMSCs with hematopoietic stem cells(HSCs)or human umbilical vein endothelial cells(HUVECs)in transwell chamber systems were constructed to test the effects of GOG stimulated BMSCs on osteoclastogenesis and angiogenesis in vitro.With the GOG stimulated BMSCs co-culture in upper chamber of transwell,the HSCs in lower chamber manifested the enhanced osteoclastogenesis.Meanwhile,the co-culture of GOG stimulated BMSCs with HUVECs showed a promotive effect on the angiogenic ability of HUVECs.The mechanism analysis on the biofunctions of the GOG stimulated BMSCs illustrated the important regulatory effects of PERK pathway on osteoclastogenesis and angiogenesis.All the results showed the biosecurity of GOG and the biological functions of GOG stimulated BMSCs in accelerating bone remodeling and tooth movement.

Photobiomodulation therapy assisted orthodontic tooth movement:potential implications,challenges,and new perspectives

Over the past decade,dramatic progress has been made in dental research areas involving laser therapy.The photobiomodulatory effect of laser light regulates the behavior of periodontal tissues and promotes damaged tissues to heal faster.Additionally,photobiomodulation therapy(PBMT),a non-invasive treatment,when applied in orthodontics,contributes to alleviating pain and reducing inflammation induced by orthodontic forces,along with improving tissue healing processes.Moreover,PBMT is attracting more attention as a possible approach to prevent the incidence of orthodontically induced inflammatory root resorption(OIIRR)during orthodontic treatment(OT)due to its capacity to modulate inflammatory,apoptotic,and anti-antioxidant responses.However,a systematic review revealed that PBMT has only a moderate grade of evidence-based effectiveness during orthodontic tooth movement(OTM)in relation to OIIRR,casting doubt on its beneficial effects.In PBMT-assisted orthodontics,delivering sufficient energy to the tooth root to achieve optimal stimulation is challenging due to the exponential attenuation of light penetration in periodontal tissues.The penetration of light to the root surface is another crucial unknown factor.Both the penetration depth and distribution of light in periodontal tissues are unknown.Thus,advanced approaches specific to orthodontic application of PBMT need to be established to overcome these limitations.This review explores possibilities for improving the application and effectiveness of PBMT during OTM.The aim was to investigate the current evidence related to the underlying mechanisms of action of PBMT on various periodontal tissues and cells,with a special focus on immunomodulatory effects during OTM.

Effective techniques and emerging alternatives in orthodontic tooth movement:A systematic review

Orthodontic procedures can be inconvenient in nature.To overcome this problem,accelerated orthodontics play a very important role to reduce existing trouble and discomfort.The most common inconvenience caused during orthodontic treatment procedures is that they are very time consuming which can result in several drawbacks,including an increased risk of tooth decay,gingival recession,and root resorption.Various methods can be employed to expedite orthodontic treatment by accelerating tooth movement,including surgical-assisted procedures,biological interventions,and the utilization of devices.These approaches effectively reduce the overall period of treatment.The purpose of this review is to study the effective techniques for orthodontic tooth movement as well as highlight various orthodontic accelerating methods in the respective approaches.Some nonsurgical studies indicated that drug-induced methods can have a therapeutic effect on tooth movement.One of the approaches involves the local administration of Vitamin 1.25D,which has been found to expedite tooth movement.Vibrational orthodontic devices are a painless and cost-effective option that is considered the least invasive approach for accelerating tooth movement.Meanwhile,surgical approach is also a successful method,wherein great results and strong PDL tissue response were observed,but they cause a lot of pain and discomfort to the patient.Therefore,due to the strengths and limitations of each procedure covered in the study,more research should be done to identify the fastest way to speed up tooth mobility。

Comprehensive management of malocclusion in maxillary fibrous dysplasia:A case report

BACKGROUND Fibrous dysplasia(FD)is a developmental hamartomatous bone disease characterized by a blend of fibrous and osseous entities.Though rarely malignant,the tumor can vary from being small and asymptomatic,to a fairly large sized lesion,progressing gradually,compromising occlusion and facial esthetics.Treatment approach depends on the stage of skeletal maturity.It primarily involves surgical management for stabilizing the disease process.Post-surgical comprehensive dental treatment is necessary for restoring form and function of the jaws and teeth.This article describes comprehensive orthodontic management of severe malocclusion in a surgically operated case of FD maxilla.CASE SUMMARY A 19-year female presented with a chief complaint of excessive gingival display when smiling.Dental history included swelling of gums around the upper right front teeth,diagnosed at the age of 15 as FD of the right anterior maxillary segment and treated with surgical recontouring of the dysplastic bone.The clinical and radiological examinations showed adequate post-surgical healing.The surgically treated dysplastic area presented with right canting of the maxillary anterior occlusal plane.The maxillary teeth were torqued palatally,with the root of the right maxillary canine exposed clinically.We discuss sequential management of the associated malocclusion with comprehensive fixed orthodontics,along with special precautions taken to prevent reactivation of the quiescent and healed lesion.CONCLUSION The adequate healing of fibro-dysplastic bone post-surgery must be allowed before initiating orthodontic tooth movement in the dysplastic bone.Periodic follow-ups are needed to monitor stability of occlusion and any relapse of the lesion.

Advancement of maxillary anterior segment by distraction osteogenesis for severe maxillary retrusion in cleft lip and palate

Background Maxillary anterior segmental distraction osteogenesis （MASDO） is a recently used method for correction of severe maxillary retrusion in cleft lip and palate （CLP） patients.In this article,we evaluated the feasibility of MASDO using rigid external distraction （RED） and rapid orthodontic tooth movement to correct severe maxillary retrusion in CLP patients.Methods Fourteen male and five female complete CLP patients between the ages of 18 and 22 years （mean age 19.7 years） at the time of distraction,with severe maxillary retrusion,were treated with the rigid external distraction （RED） device after maxillary anterior osteotomy.Rapid orthodontic tooth movement was started one week after the MASDO.Standard profile photographic,cephalometric films were obtained preoperatively and after therapy.Sella-nasion-point A （SNA） and Sella-nasion-point B （SNB） angles were measured to reflect changes in maxillary and mandibular position,and the distance between anterior nasal spine and posterior nasal spine （ANS-PNS） was measured to represent the maxillary dental arch length.Results The SNA angle increased from an average of 74.6° （range 73.0°-78.0°）,preoperatively,to 83.4° （range 78.6°-88.0°） after the RED was removed （P ＜0.01）.All cases of severe maxillary retrusion were improved.Nine patients＇ profiles became harmonious after therapy.One patient had a bimaxillary protrusion deformity and needed further surgery.The regenerate alveolar crest and edentulous space on both segments was almost completely eliminated after rapid orthodontic tooth movement.Conclusion MASDO with the RED system and rapid orthodontic tooth movement is a successful way of correcting severe maxillary retrusion in CLP patients.