Quantitative approach for the prediction of tooth movement during orthodontic treatment

The orthodontic treatment is aimed to displace and/or rotate the teeth to obtain the functionally correct occlusion and the best aesthetics and consists in applying forces and/or couples to tooth crowns. The applied loads are generated by the elastic recovery of metallic wires linked to the tooth crowns by brackets. These loads generate a stress state into the periodontal ligament and hence, in the alveolar bone, causing the bone remodeling responsible for the tooth movement. The orthodontic appliance is usually designed on the basis of the clinical experience of the orthodontist. In this work, a quantitative approach for the prediction of the tooth movement is presented that has been developed as a first step to build up a computer tool to aid the orthodontist in designing the orthodontic appliance. The model calculates the tooth movement through time with respect to a fixed Cartesian frame located in the middle of the dental arch. The user interface panel has been designed to allow the orthodontist to manage the standard geometrical references and parameters usually adopted to design the treatment. Simulations of specific cases are reported for which the parameters of the model are selected in order to reproduce forecasts of tooth movement matching data published in experimental works.     

Low-Intensity Pulsed Ultrasound Accelerates Tooth Movement via Activation of the BMP-2 Signaling Pathway

The present study was designed to determine the underlying mechanism of low-intensity pulsed ultrasound (LIPUS) induced alveolar bone remodeling and the role of BMP-2 expression in a rat orthodontic tooth movement model. Orthodontic appliances were placed between the homonymy upper first molars and the upper central incisors in rats under general anesthesia, followed by daily 20-min LIPUS or sham LIPUS treatment beginning at day 0. Tooth movement distances and molecular changes were evaluated at each observation point. In vitro and in vivo studies were conducted to detect HGF (Hepatocyte growth factor)/Runx2/BMP-2 signaling pathways and receptor activator of NFκB ligand (RANKL) expression by quantitative real time PCR (qRT-PCR), Western blot and immunohistochemistry. At day 3, LIPUS had no effect on the rat orthodontic tooth movement distance and BMP-2-induced alveolar bone remodeling. However, beginning at day 5 and for the following time points, LIPUS significantly increased orthodontic tooth movement distance and BMP-2 signaling pathway and RANKL expression compared with the control group. The qRT-PCR and Western blot data in vitro and in vivo to study BMP-2 expression were consistent with the immunohistochemistry observations. The present study demonstrates that LIPUS promotes alveolar bone remodeling by stimulating the HGF/Runx2/BMP-2 signaling pathway and RANKL expression in a rat orthodontic tooth movement model, and LIPUS increased BMP-2 expression via Runx2 regulation.     

A novel method for the three-dimensional (3-D) analysis of orthodontic tooth movement-calculation of rotation about and translation along the finite helical axis.

The purpose of this study was to establish a novel method for evaluating orthodontic tooth movement in three-dimensional (3-D) space. The present system consisted of the following procedures at a given treatment period: (1) 3-D tooth positions were measured with a 3-D surface-scanning system using a slit laser beam; (2) the 3-D shape data were registered automatically at the maxillary first molars, and the coordinate systems were normalized; (3) the rotation matrix and translation vector were calculated from the automatic registration of the two position data for a given tooth; (4) the finite helical axes of teeth were calculated as the locus of zero rotational displacement; and (5) tooth movement was presented as rotation about and translation along the finite helical axis. To test this system, a male patient (age 22 yr 2 months) with Angle Class III malocclusion and moderate crowding of the anterior teeth, who had been treated using a standard multi-bracket appliance, was used as a model case in this study. Impressions for a dental cast model were taken at five phases; immediately before and after application of the appliance, and 10 days, 1 month and 2 months after beginning treatment. The results demonstrated that the present analytical method can more simply describe the movement of a given tooth by rotation about and translation along the finite helical axis, and provides quantitative visual 3-D information on complicated tooth movement during orthodontic treatment.     

The Biomechanical Function of Periodontal Ligament Fibres in Orthodontic Tooth Movement

Orthodontic tooth movement occurs as a result of resorption and formation of the alveolar bone due to an applied load, but the stimulus responsible for triggering orthodontic tooth movement remains the subject of debate. It has been suggested that the periodontal ligament (PDL) plays a key role. However, the mechanical function of the PDL in orthodontic tooth movement is not well understood as most mechanical models of the PDL to date have ignored the fibrous structure of the PDL. In this study we use finite element (FE) analysis to investigate the strains in the alveolar bone due to occlusal and orthodontic loads when PDL is modelled as a fibrous structure as compared to modelling PDL as a layer of solid material. The results show that the tension-only nature of the fibres essentially suspends the tooth in the tooth socket and their inclusion in FE models makes a significant difference to both the magnitude and distribution of strains produced in the surrounding bone. The results indicate that the PDL fibres have a very important role in load transfer between the teeth and alveolar bone and should be considered in FE studies investigating the biomechanics of orthodontic tooth movement.     

Investigation of effective intrusion and extrusion force for maxillary canine using finite element analysis

Abstract

Orthodontic tooth movement is mainly regulated by the biomechanical responses of loaded periodontal ligament (PDL). We investigated the effective intervals of orthodontic force in pure maxillary canine intrusion and extrusion referring to PDL hydrostatic stress and logarithmic strain. Finite element analysis (FEA) models, including a maxillary canine, PDL and alveolar bone, were constructed based on computed tomography (CT) images of a patient. The material properties of alveolar bone were non-uniformly defined using HU values of CT images; PDL was assumed to be a hyperelastic–viscoelastic material. The compressive stress and tensile stress ranging from 0.47 to 12.8?kPa and 18.8 to 51.2?kPa, respectively, were identified as effective for tooth movement; a strain 0.24% was identified as the lower limit of effective strain. The stress/strain distributions within PDL were acquired in canine intrusion and extrusion using FEA; root apex was the main force-bearing area in intrusion–extrusion movements and was more prone to resorption. Owing to the distinction of PDL biomechanical responses to compression and tension, the effective interval of orthodontic force was substantially lower in canine intrusion (80–90?g) than in canine extrusion (230–260?g). A larger magnitude of force remained applicable in canine extrusion. This study revised and complemented orthodontic biomechanical behaviours of tooth movement with intrusive–extrusive force and could further help optimize orthodontic treatment.     

Concept for development of new individual treatment devices in orthodontics using 3-dimensional numerical simulation of bone remodeling]

The present study is part of a research project that includes different components for the simulation of orthodontic tooth movement and comparing experimental results. This concept includes the development of a bone remodelling algorithm, as well as experimental studies on tooth movement. After the acquisition and evaluation of specific experimental data of the patient's situation, the individual components have to be integrated to verify and forecast tooth movement. The aim is to design individual treatment devices as well as to shorten treatment while making it more effective. The geometry of the teeth and that of the surrounding alveolar bone both influence the orthodontic tooth movement. For this reason, an exact morphological tooth model for the valid simulation of the tooth movement is needed, and can be constructed from computed tomography data. Simulation of tooth movement can then be compared with "in vivo" measurements of the orthodontic tooth movement. In this study, a specially developed hybrid retraction spring is employed. This spring enables the application of a defined, almost constant force system. The "in vivo" determined tooth movement is simulated with the aid of special positioning and measuring devices. Meanwhile, the active force system can be determined by 6-component force/moment sensors. The experimentally measured force system, "in vivo" measurements of tooth movement and the CT model are now available for numerical simulation for the first time.     

Micro-CT监测尼古丁对大鼠正畸牙移动过程中牙周改建的影响

目的:探讨不同摄取量的尼古丁对大鼠正畸过程牙周改建的影响。方法:选择120只雄性Wistar大鼠并将其随机分为四组:A组-空白对照,B组-正畸模型,C组-正畸并0.01 mg/m L尼古丁给药,D组-正畸并1 mg/m L尼古丁给药。分别于实验开始后第1、3、7、14、21天通过Micro-CT和HE染色观察模型牙齿移动距离和牙周组织改变并通过ELISA实验检测IL-17的表达。结果:Micro-CT扫描显示:正畸建模组相对于空白对照组在牙移动距离、骨体积分数、骨密度等指标均有明显变化,变化最大幅度发生在D组,B、C两组之间的差异没有统计学意义(P0.05)。21天,D组移动距离达到0.80±0.06 mm,明显高于B、C组(P0.05)。相较于空白对照组(A组),B、C、D三组Micro-CT测量的骨体积分数、骨密度、骨小梁厚度均降低,D组骨密度值降至1108.36±8.86mg/cm3。HE染色结果显示:D组在21天时破骨细胞增多并出现牙根吸收陷窝伴牙周膜纤维排列混乱;ELISA检测显示B、C组IL-17的含量在第7天时达到峰值,D组则在14天含量最高。结论:高浓度的尼古丁可加速正畸牙齿的移动速度及牙槽骨吸收,增加牙周组织中的破骨细胞及IL-17表达水平。     

Tension force-induced bone formation in orthodontic tooth movement via modulation of the GSK-3β/β-catenin signaling pathway

Orthodontic force-induced osteogenic differentiation and bone formation at tension sites play a critical role in orthodontic tooth movement. However, the molecular mechanism underlying this phenomenon is poorly understood. In the current study, we investigated the involvement of the GSK-3β/β-catenin signaling pathway, which is critical for bone formation during tooth movement. We established a rat tooth movement model to test the hypothesis that orthodontic force may stimulate bone formation at the tension site of the moved tooth and promote the rate of tooth movement via regulation of the GSK-3β/β-catenin signaling pathway. Our results showed that continued mechanical loading increased the distance between the first and second molar in rats. In addition, the loading force increased bone formation at the tension site, and also increased phospho-Ser9-GSK-3β expression and β-catenin signaling pathway activity. Downregulation of GSK-3β activity further increased bone parameters, including bone mineral density, bone volume to tissue volume and trabecular thickness, as well as ALP- and osterix-positive cells at tension sites during tooth movement. However, ICG-001, the β-catenin selective inhibitor, reversed the positive effects of GSK-3β inhibition. In addition, pharmaceutical inhibition of GSK-3β or local treatment with β-catenin inhibitor did not influence the rate of tooth movement. Based on these results, we concluded that GSK-3β/β-catenin signaling contributes to the bone remodeling induced by orthodontic forces, and can be used as a potential therapeutic target in clinical dentistry.     

Numerical analysis of orthodontic treatment elements of pseudo-elastic NiTi alloys]

In orthodontic treatment malpositions of teeth are often corrected by fixed appliances, consisting, in part, of loops made by the orthodontist. The most important alloys in use are steel, cobalt-chromium, or titanium-molybdenium alloys. The static force systems of fixed appliances made of these materials are well known from experimental and numerical studies, but as they may change during tooth movement, we are often confronted with problems in therapy. The introduction of pseudoelastic nickel titanium alloys (NiTi) into orthodontic treatment, offers the chance of improving the effectiveness and reliability of orthodontic devices. In the present paper a plane finite element (FE) for the analysis of orthodontic loops is presented. It enables the determination of the nonlinear behaviour of pseudoelastic NiTi-alloys and is capable of simulating large structural displacements and rotations accompanied by moderate strains. A comparative numerical and experimental study shows the efficiency of this element. The associated results reflect pseudoelastic effects on certain loop designs, and reveal the benefits for the orthodontist and his patients.     

Histological evidence that metformin reverses the adverse effects of diabetes on orthodontic tooth movement in rats

This study evaluated the effects of metformin on orthodontic tooth movement in a rat model of type 2 diabetes mellitus. Rats were fed a high-fat diet for 4 weeks to induce fat accumulation and insulin resistance, and then injected with a low dose of streptozotocin (35 mg/kg) intraperitoneally to induce type 2 diabetes. An orthodontic appliance was placed in normoglycemic, type 2 diabetes, and type 2 diabetes with metformin-administrated rats. After 14 days, type 2 diabetes rats exhibited greater orthodontic tooth movement and had a higher number of tartrate-resistant acid phosphatase-positive osteoclasts, stronger cathepsin K expression, and weaker alkaline phosphatase immunostaining than normoglycemic rats. Metformin administration resulted in normalization of osteoclast numbers, cathepsin K immunostaining, and of tooth movement as well as partly recovery of alkaline phosphatase expression in diabetic rats. Metformin also reduced sclerostin expression and improved the immunolocalization of dentin matrix protein 1 in osteocytes of type 2 diabetes rats. These results suggest that metformin administration reversed the adverse effects of diabetes on orthodontic tooth movement.     

Experimental model of tooth mobility in the human "in vivo"]

The aim of the present study was to investigate experimentally the mechanical properties of tooth deflection under external loading. These properties have a significant impact on tooth movement during orthodontic treatment. The stresses and strains caused by tooth movement influence bone remodelling, which is the basis of orthodontic treatment. The movement of a tooth as a direct reaction to the forces acting on it is termed "initial" movement. It is nonlinear and has a clearly time-dependent component. While the initial tooth movement represents the totality of the reaction mechanisms of all the tissues of the tooth unit, it is determined primarily by the mechanical properties of the periodontal ligament (PDL). The PDL is the softest tissue of the tooth unit and is therefore subject to the largest deformations when forces act on the crown of the tooth. The objective of orthodontic treatment is to achieve as precise and rapid tooth movement as possible, without provoking such undesired effects as bone and root resorption. To enable the implementation of an optimal orthodontic force system that meets these requirements, a thorough knowledge of the biomechanics of tooth movement is a must.     

A mechanobiological model of orthodontic tooth movement

Orthodontic tooth movement is achieved by the process of repeated alveolar bone resorption on the pressure side and new bone formation on the tension side. In order to optimize orthodontic treatment, it is important to identify and study the biological processes involved. This article presents a mechanobiological model using partial differential equations to describe cell densities, growth factor concentrations, and matrix densities occurring during orthodontic tooth movement. We hypothesize that such a model can predict tooth movement based on the mechanobiological activity of cells in the PDL. The developed model consists of nine coupled non-linear partial differential equations, and two distinct signaling pathways were modeled: the RANKL–RANK–OPG pathway regulating the communication between osteoblasts and osteoclasts and the TGF-β pathway mediating the differentiation of mesenchymal stem cells into osteoblasts. The predicted concentrations and densities were qualitatively validated by comparing the results to experiments reported in the literature. In the current form, the model supports our hypothesis, as it is capable of conceptually simulating important features of the biological interactions in the alveolar bone—PDL complex during orthodontic tooth movement.     

Simulation of bone remodelling in orthodontic treatment

Orthodontic treatments not only displace irregular teeth but also induce responses in surrounding bone tissues. Bone remodelling is regarded as the regulatory mechanism triggered by mechanical loading. This study was aimed at investigating the effect of orthodontic loading on both tooth movement and neighbouring bone density distribution. A set of computational algorithms incorporating both external and internal remodelling mechanisms was implemented into a patient-specific 3D finite element (FE) model to investigate and analyse orthodontic treatment under four typical modes of orthodontic loading. The consequence of orthodontic treatment was reproduced numerically by using this FE-based technique. The results indicated that the diverse modes of orthodontic loading would result in different magnitudes of tooth movement and particular morphology of bone density distribution. It is illuminated that the newly developed algorithms may replicate the clinical situation more closely compared with the previous proposed method.     

A new method for finite element simulation of orthodontic appliance-teeth-periodontium-alveolus system

This paper describes a new simulation method to analyze the initial behavior of the total system comprising orthodontic appliance, teeth, and their supporting structures. It is based on a finite element method which additionally takes account of a rotational degree of freedom. Beam and rod elements are used for finite element idealization of orthodontic appliance. Through spring elements it is connected with the teeth supported by the alveolar structures. The technique of 'initial strain' is introduced so as to analyze the effects of a gable bend and activation on the force system which is delivered by the orthodontic appliance. As compared with the photoelastic technique hitherto used, this method serves to investigate systematically and quantitatively the initial aspect of orthodontic tooth movement.     

A visco-elastic model for the prediction of orthodontic tooth movement

This study presents a biomechanical model of orthodontic tooth movement. Although such models have already been presented in the literature, most of them incorporate computationally expensive finite elements (FE) methods to determine the strain distribution in the periodontal ligament (PDL). In contrast, the biomechanical model presented in this work avoids the use of FE methods. The elastic deformation of the PDL is modelled using an analytical approach, which does not require setting up a 3D model of the tooth. The duration of the lag phase is estimated using the calculated hydrostatic stresses, and bone remodelling is predicted by modelling the alveolar bone as a viscous material. To evaluate the model, some typically used motion patterns were simulated and a sensitivity analysis was carried out on the parameters. Results show that despite some shortcomings, the model is able to describe commonly used motion patterns in orthodontic tooth movement, in both single- and multi-rooted teeth.     

正畸牙移动相关信号通路研究进展

<正>畸牙移动是在机械力的作用下,通过对牙周膜产生牵张或压缩的力来引起牙周组织在生理限度内的组织改建,从而达到牙齿移动、矫治畸形的目的。由于没有明显的年龄限制,正畸矫治在全球范围已变得越来越普遍。因此,相关的研究也日益增多。牙齿移动的生物学基础是正畸力作用于牙周组织激活一系列信号转导通路,进而引起牙周膜的修复改建。为指导临床、加速正畸矫治疗程提供新的思路,本文综述了近年来有关正畸牙移动相关信号通路的研究进展。发现最新的研究集中在MAPK信号通路,Wnt/β-catenin信号通路,PI3K/AKt/m TOR信号通路,BMP-2信号通路,Caspase-3介导的凋亡通路较多。但是正畸牙移动引起的牙周组织改建是一个多种生物力学信号转导通路相互调节相互作用的过程,对于上述信号通路之间的相互关系还有待于我们更进一步的探索。     

A novel adipocytokine, vaspin inhibits platelet-derived growth factor-BB-induced migration of vascular smooth muscle cells

Orthodontic treatment induces various biological responses, including tooth movement and remodeling of alveolar bone. Although some studies have investigated the contribution of orthodontic procedures to changes in saliva conditions, little is known about the effects of different treatment durations on the saliva proteome. To identify the discriminating protein profiles in unstimulated whole saliva of orthodontic patients with different treatment durations, we used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) combined with magnetic bead, and peptide mass fingerprints were created by scanning MS signals. Saliva samples from 40 patients (10 in each of four groups: the group without an appliance and groups under treatment for 2, 7, and 12 months) were analyzed. The results showed eight mass peaks with significant differences. Furthermore, mass peak intensities at proteins 1817.7, 2010.7, 2744 and 2710.2 Da represented a steady time-dependent increasing trend, whereas protein 4134 Da exhibited a decreasing tendency. Differential expression of the peptidome profile also occurred in the multiple comparisons, and we established a fitting model. Thus, the potential discriminating biomarkers investigated in this study reflected the complicated changes in periodontal tissues during orthodontic treatment and indicated dynamic interactions between orthodontic treatment and the saliva proteome. The results provide novel insights into alterations in salivary proteins due to different orthodontic treatment durations and may lead to the development of a therapeutic monitoring strategy for orthodontics.     

Expression of genes for gelatinases and tissue inhibitors of metalloproteinases in periodontal tissues during orthodontic tooth movement

Orthodontic tooth movement progresses by a combination of periodontal ligament (PDL) tissue and alveolar bone remodeling processes. Besides the remodeling of alveolar bone around the moving teeth, the major extracellular matrix (ECM) components of PDLs, collagens, are degenerated, degraded, and restructured. Matrix metalloproteinases (MMPs) and their specific inhibitors, tissue inhibitors of metalloproteinases (TIMPs), act in a co-ordinated fashion to regulate the remodeling of periodontal tissues. We hypothesized that the expression levels of the genes for MMP-2, MMP-9, and TIMPs 1–3 are increased transiently in the periodontal tissue during orthodontic tooth movement. To test this hypothesis, we employed an animal model of tooth movement using rats, as well as in situ hybridization to analyze the expression levels of Mmp-2, Mmp-9, and Timps 1-3. The expression levels of these genes increased transiently in cells of periodontal tissues, which include cementoblasts, fibroblasts, osteoblasts, and osteoclasts, at the compression side of the moving teeth. The transient increases in gene expression at the tension side were mainly limited to osteoblasts and cementoblasts. In conclusion, the expression levels of Mmp-2, Mmp-9, and Timps 1-3 increase transiently during orthodontic tooth movement at both the tension and compression sides. The expression of these genes is regulated differentially in the periodontal tissue of the tension side and compression side. This altered pattern of gene expression may determine the rate and extent of remodeling of the collagenous ECM in periodontal tissues during orthodontic tooth movement.     

Using Micro-Computed Tomography to Evaluate the Dynamics of Orthodontically Induced Root Resorption Repair in a Rat Model

Objective

To observe dynamic changes in root resorption repair, tooth movement relapse and alveolar bone microstructure following the application of orthodontic force.

Materials and Methods

Forces of 20 g, 50 g or 100 g were delivered to the left maxillary first molars of fifteen 10-week-old rats for 14 days. Each rat was subjected to micro-computed tomography scanning at 0, 3, 7, 10, 14, 28 and 42 days after force removal. The root resorption crater volume, tooth movement relapse and alveolar bone microarchitecture were measured at each time point.

Results

From day 3 to day 14, the root resorption volume decreased significantly in each group. In the 20-g force group, the root resorption volume gradually stabilized after 14 days, whereas in the 50-g and 100-g force groups, it stabilized after 28 days. In all groups, tooth movement relapsed significantly from day 0 to day 14 and then remained stable. From day 3 to day 10, the 20-g group exhibited faster relapse than the 50-g and 100-g groups. In all groups, the structure model index and trabecular separation decreased slowly from day 0 to day 10 and eventually stabilized. Trabecular number increased slowly from day 0 to day 7 and then stabilized.

Conclusions

The initial stage of root resorption repair did not change significantly and was followed by a dramatic repair period before stabilizing. The most serious tooth movement relapse occurred immediately after the appliance was removed, and then the tooth completely returned to the original position.