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9321 - Review Paper
9321 - Review Paper
9321 - Review Paper
* Professor & Head, Department of Orthodontics and Dentofacila Orthopaedics, Maharana Pratap College of Dentistry, Gwalior, India
** Post Graduate Student, Department of Orthodontics and Dentofacila Orthopaedics, Maharana Pratap College of Dentistry, Gwalior,
India
*** Assistant Professor, Department of Orthodontics and Dentofacila Orthopaedics, Darshan Dental College & Hospital, Udaipur, India
† Post Graduate Student, Department of Orthodontics and Dentofacila Orthopaedics, Maharana Pratap College of Dentistry, Gwalior,
India
†† Assistant Professor, Department of Oral and Maxillofacial Surgery, RR Dental College, Udaipur, India
††† Assistant Professor, Department of Orthodontics and Dentofacila Orthopaedics, Darshan Dental College & Hospital, Udaipur, India
_________________________________________________________________________
ABSTRACT attempts have been made to create different
Duration of the orthodontic treatment has approaches in order to achieve quicker results but
always been an issue in the orthodontic still there are a lot of unanswered questions
fraternity. Nowadays, there is an increased towards most of the technique. Before going into
tendency for researches to focus on details of these attempts, we need to understand
accelerating methods for tooth movement due the basics of orthodontic tooth movements and
to the huge demand for adults for a shorter the factors that initiate inhibition and delayed
orthodontic treatment time. Unfortunately, tooth movement. Orthodontic tooth movement
long orthodontic treatment time poses several occurs in the presence of mechanical stimuli
disadvantages like higher predisposition to resulting remodeling of alveolar bone and
caries, gingival recession, and root resorption. periodontal ligament. Bone remodeling is a
This increases the demand to find the best process in which bone resorption take place in
method to increase tooth movement with the pressure site and bone formation takes place in
least possible disadvantages. The purpose of the tension site.[1] Orthodontic tooth movement is
this study is to view the successful approaches controlled by amount of applied force and
in tooth movement and to highlight the newest biological responses from the periodontal
technique in tooth movement. A total of 50 ligament.[2] The force applied to the teeth alters
articles were reviewed in tooth movement and the blood flow leading to the secretion of
different inflammatory mediators such as
related discipline. In various researches done,
Cytokines, Growth factors etc. As a result of
cytokines PTH, Vit D, have shown good results.
these secretions, remodeling of the bone
Due to the advantage and disadvantage of each
occurs.[3,4] There are three phases of tooth
approach further investigation should be done
movement: the initial phase, which is
to determine the best method to accelerate
characterized by rapid movement after the
tooth movement.
application of force; followed by a lag period,
KEYWORDS: Biological approaches, tooth
where little or no movement, and the last phase,
movement, orthodontic movement
where gradualor sudden increase of movement
occurs.[5] The early phase of tooth movement
INTRODUCTION
involves acute inflammatory responses
Orthodontics has been developing greatly in
characterized by leucocytes migrating out of
achieving the desired results both clinically and
blood capillaries and producing cytokines, which
technically. Continous modification of wires and
stimulates the excretion of prostaglandins and
brackets has also increased the efficiency of
growth factors.[6] The acute phase is followed by
orthodontic treatment. However biomechanical
the chronic phase that involves the proliferation
systems have reached their limits and hence there
of fibroblast, endothelial cells, osteoblasts, and
is a need to develop new methods that may
alveolar bone marrow cells remodeling process.[4]
accelerate the teeth movement. Number of
some scientist to its role in the acceleration of weekly on polyvinyl siloxane impressions which
tooth movement; 1,25 dihydroxycholecalciferol is were scanned digitally. There was no significant
a hormonal form of vitamin D and plays an difference between the relaxin and the placebo
important role in calcium homeostasis with control group regarding the acceleration and
calcitonin and parathyroid hormone (PTH). relapse.[21] However, the mechanism of how
Another set of investigators,[16] has made an relaxin accelerates tooth movement is not yet
experiment where they have injected vitamin D fully understood.
metabolite on the PDL of cats for several weeks; EFFECT OF PROSTAGLANDIN ON
it was found that vitamin D had accelerated tooth TOOTH MOVMENT
movement at 60% more than the control group Prostaglandins (PGs) are inflammatory mediator
due to the increasement of osteoclasts on the and a paracrine hormone that acts on nearby cells;
pressure site as detected histologically. A it stimulates bone resorption by increasing
comparison between local injection of vitamin D directly the number of osteoclasts. In vivo and in
and PGEs on two different groups of rats was also vitro experiments were conducted to show clearly
investigated. It was found that there is no the relation between PGs, applied forces, and the
significant difference in acceleration between the acceleration of tooth movement. Yamasaki[10,11]
two groups. However, the number of osteoblasts was among the first to investigate the effect of
on the pressure side which was injected by local administration of prostaglandin on rats and
vitamin D was greater than on the PGE2 side. monkeys. In addition, experiments[7] done in have
This indicates that vitamin D may be more shown that injections of exogenous PGE2 over an
effective in bone turnover.[17] extended period of time caused acceleration of
EFFECT OF RELAXIN ON TOOTH tooth movements in rats. Furthermore, chemically
MOVEMENT produced PGE2 has been studied in human trials
Relaxin effect has also been investigated. Relaxin with split-mouth experiments in the first premolar
is a hormone that helps during childbirth by extraction cases. In these experiments the rate of
widening of the pubic ligaments in females and is distal retraction of canines was 1.6-fold faster
suggested to be present in cranial suture and than the control side.[12]
PDL.[29] The role of relaxin is known in the CONCLUSION
remodeling of soft tissue rather than remodeling In general all the approaches have their own flaws
of bone. It has been shown that it increases and that is the reason behind their limited use
collagen in the tension site and decreases it in clinically. These approaches have the potential to
compression site during orthodontic be the next frontier for orthodontics and resources
movement.[30,31] Also, the administration of but still further investigations and studies are
human relaxin may accelerate the early stages of required to decrease their unwanted effects and
orthodontic tooth movement in rat increase their efficiency and acceptability in the
[20]
experiments. However, another study showed clinical practise.
that human relaxin does not accelerate CONFLICT OF INTEREST & SOURCE OF
orthodontic tooth movement in rats, but can FUNDING
reduce the level of PDL organization and The author declares that there is no source of
mechanical strength of PDL and increase tooth funding and there is no conflict of interest among
mobility.[21] In these experiments in vitro studies all authors.
were also performed to test the PDL mechanical BIBLIOGRAPHY
strength and tooth mobility using tissue from 1. Davidovitch Z. Tooth movement. Crit Rev
additional 20 rats that had previously received the Oral Biol Med 1991;2(4):411-50.
same relaxin treatment for several days.[21] The 2. Meikle MC. The tissue, cellular, and
remodeling of PDL by relaxin might reduce the molecular regulation of orthodontic tooth
rate of relapse after orthodontic treatment as movement: 100 years after Carl Sandstedt.
suggested by others.[32] Recently, randomized Eur J Orthod 2006;28(3):221-40.
clinical trials on humans were done by weekly 3. Davidovitch Z, Nicolay OF, Ngan PW,
injections of 50 μg of relaxin or placebo control Shanfeld JL. Neurotransmitters, cytokines,
for 8 weeks. Tooth movement was measured and the control of alveolar bone remodeling