New therapeutic modalities to modulate orthodontic tooth movement

Abstract

Modulation of orthodontic tooth movement (OTM) is desirable not only to patients because it shortens treatment time, but also to orthodontists, since treatment duration is associated with increased risk of gingival inflammation, decalcification, dental caries, and root resorption. The increased focus on the biological basis of tooth movement has rendered Orthodontics a more comprehensive specialty that incorporates facets of all fields of medicine. Current knowledge raises the possibility of using new therapeutic modalities for modulation of OTM, such as corticotomy, laser therapy, vibration (low-intensity pulsed ultrasound), local injections of biomodulators and gene therapy; with the latter being applicable in the near future. They are intended to enhance or inhibit recruitment, differentiation and/or activation of bone cells, accelerate or reduce OTM, increase stability of orthodontic results, as well as assist with the prevention of root resorption. This article summarizes recent studies on each one of these therapeutic modalities, provides readers with information about how they affect OTM and points out future clinical perspectives.

Effectiveness of adjunctive interventions for accelerating orthodontic tooth movement: a systematic review of systematic reviews

“…It has been well recognised that orthodontic tooth movement (OTM) is achieved through a series of biological events, including the remodelling of alveolar bone, the periodontal ligament, the vasculature and neural elements under the stimulus of orthodontic forces . To date, numerous novel adjunctive methods have been reported to accelerate this process and shorten the treatment duration in clinical trials and case reports . However, the clinical application of these techniques remains limited, a major reason of which is the inconclusive results and unreliable methodology of the clinical research studies .…”

Effect of low-intensity pulsed ultrasound on the activity of osteoclasts: An in vitro study

“…the local injection of exogenous biological molecules, gene therapy, as well as the performance of surgical approaches, and the use physical stimuli with device-assisted therapies (Alikhani et al, 2013;Nimeri, Kau, Abou-Kheir, & Corona, 2013;Andrade, Sousa, & Silva, 2014;Camacho and Cujar, 2014). Systematic reviews on those techniques (Long et al, 2013;Ge et al, 2015;Gkantidis, Mistakidis, Kouskoura, & Pandis, 2014;Hoogeveen, Jansma, & Ren, 2014) showed insufficient evidence regarding the effectiveness of most of these therapies, but still pointed out that both corticotomy, and low-level laser stimulation seem to be able to significantly provide increased alveolar bone turnover and tooth movement acceleration.…”

Selective Alveolar Corticotomy to Intrude Overerupted Maxillary First Molars: Analysis of Pulp Vitality

“…This surgical procedure has become an interesting alternative to increase the rate of tooth movement in adults (Andrade et al, 2014), being an alternative to reduce the treatment time and increase the stability of orthodontic treatment for complex occlusal problem (Kole, 1959).…”