Gingival recession is one of the common mucogingival problems during the orthodontic treatment. The causes of the gingival recession are similar to gingival recession in patients with periodontal diseases. Accumulation of bacterial deposits around the natural teeth induces the gingival inflammation and gingival recession occurs in the teeth with the lack of the supporting bone. However, malpositioned teeth which are labially positioned teeth or rotated teeth are more risky for gingival recession. Once root is exposed to oral cavity due to gingival recession, the orthodontic tooth movement is compromised and esthetic problems appeared. In addition, excessive gingival recession over the mucogingival junction jeopardizes the oral hygiene control, which has a risk of further gingival recession and bone loss around the tooth. To cover exposed root or to prevent further gingival recession, mucogingival surgery with gingival graft is recommended for the patients under orthodontic treatment. This case report aimed to present the mucogingival treatments of gingival recession observed during orthodontic treatment. Case I had had initial slight gingival recession before the orthodontic treatment. However, during the retraction phases, the gingival recession progressed and the periodontal treatment was referred. In case II, miller Class III gingival recession was occurred after correction of rotation. Both cases were treated by coronally advanced flap with free gingival grafts and recovered to the level of adjacent teeth despite of complete root coverage was not achieved in Case II. After periodontal treatment, orthodontic treatment was successfully completed. In conclusion, mucogingival surgery during the orthodontic treatment is recommended for the successful orthodontic treatment as well as periodontal health.
Objective: This study aimed to identify the clinical effectiveness of two different penetration depths of micro-osteoperforations (MOPs) on the rate of orthodontic tooth movement. Methods: Twenty-four patients requiring the removal of the upper first premolar teeth were selected and randomly divided into two groups. The control group participants did not undergo MOPs. Participants in the experimental group underwent three MOPs each at 4-mm (MOP-4) and 7-mm (MOP-7) depths, which were randomly and equally performed to either the left or right side distal to the canine. The retraction amount was measured on three-dimensional digital models on the 28th day of retraction. MOP-related pain was measured using a visual analog scale (VAS). Between-group statistical differences in the VAS scores were determined using an independent t-test and those in canine retraction were determined using analysis of variance and post-hoc Tukey test. Results: No significant difference was found between the MOP-4 (1.22 ± 0.29 mm/month) and MOP-7 (1.29 ± 0.31 mm/month) groups in terms of the canine retraction rate. Moreover, both the groups demonstrated a significantly higher canine movement than the control group (0.88 ± 0.19 mm/month). MOPs did not significantly affect the mesialization of the posterior teeth (p > 0.05). Moreover, the pain scores in the MOP-4 and MOP-7 groups were similar and showed no statistically significant difference. Conclusions: Three MOPs with a depth of 4 mm can be performed as an effective method to increase the rate of tooth movement. However, three MOPs with depths of 4-7 mm does not additionally enhance tooth movement.
Choi, Bohm;Kim, Tae-Gun;Han, Seung-Hee;Park, Yoon-Hee;Lee, Won
Journal of Korean Dental Science
/
v.5
no.1
/
pp.37-44
/
2012
Purpose: Among the facilitation of tooth movement in adult orthodontic treatment methods, surgical approaches are gaining popularity but complications following mechanical bone reduction are a problem. In this study, tooth movement was observed after alveolar bone was chemically demineralized to verify whether tooth movement had been facilitated. Materials and Methods: Twelve rabbits were used. In the experimental group, the alveolar bone of the left first molar area was exposed and demineralized. Thirty seven percents phosphoric acid was applied for 5 minutes for demineralization. The opposite first molar area was used as control. Two teeth were pulled with 200 g force and 4 rabbits each were sacrificed at 3, 7, and 14 days after the force was applied. Histologic examination was done with hematoxylin and eosin and tartrate-resistant acid phosphatase staining. Result: The histologic examination results revealed more bone resorption in the demineralized area. As time passed, the number of osteoclasts increased in the compressed area. The amount of tooth movement was larger in the experimental group compared to the control group but the difference was not statistically significant. Conclusion: The demineralization with etchant resulted in limited bone resorption, more tooth movement and less damage of the cementum after applied orthodontic force.
Tooth movement would be impeded by frictional force arised between archwire and tube, bracket or elastics in the fixed orthodontic appliances, which could be changed variably by such several factors as the contact area, normal (perpendicular) force and the condition of contact surface. There were many literatures about frictional force in the orthodontic region, but different results were obtained from little controlled research so that was very difficult in clinical application. Therefore we have reviewed comprehensively previous literatures about frictional force and thus several results were obtained as follows: 1. For use species of the orthodontic wire, frictional force was influenced mainly by surface roughness of wire in the absence of binding, while that was influenced mainly by normal force in high binding angulation. 2. For the cross-section and diameter of the wire, the contact area influenced mainly on frictional force in the absence of binding, while wire stiffness influenced mainly on frictional force in high binding angulation. 3. The greater the bracket width, the greater frictional force, and frictional force of the plastic bracket was larger than that of the metal bracket. 4. For ligation type, frictional force of the stainless steel ligation was larger than that of the elastic ligation, and frictional force was directly proportional to ligation force. 5. Variable frictional force were occured from the saliva combined with such another factors as normal force and mode of surface oxide et al.
Collective changes caused by orthodontic tooth movement evaluated in a specific treatment modality could give suggestive information on the specific treatment strategy. The aim of this study was to investigate retrospectively the characteristics of the orthodontic tooth movement during surgical-orthodontic treatment in order to provide an effective presurgical orthodontic treatment planning for the maxillary premolar extraction modality In the skeletal Class III malocclusion patient. Pre- and post-treatment dental casts of skeletal Class III malocclusion patients with nonextraction (N=:24) and the maxillary premolar extraction (N=31) were collected. The angulation and inclination measuring gauge(Invisitech Co. Seoul, Korea) was used to evaluate the orthodontic tooth movement. The changes in the maxillary and mandibular dental arch widths were also measured from the canines to the second molars. As a result, more palatal inclination change in the maxillary dentition was found with the premolar extraction modality than with the nonextraction modality. Linear regression analysis showed that the inter-arch width coordination was mainly due to the inclination changes of maxillary posterior teeth We conclude that the indications and proper treatment planning for surgical-orthodontic treatment in skeletal Class III malocclusion with maxillary premolar extraction could depend partly on the magnitude of the transverse inter-arch coordination especially in the maxillary dentition.
There are evidences that exogenous electric currents are capable of enhancing bone formation and resolution, and that the conversion of the bioelectric response to biochemical activity provides the directional component of orthodontic tooth movement. In addition, evidence has implicated cyclic nucleotides in alveolar bone cellular activation mechanism during orthodontic tooth movement. In view of these evidences, this study was performed to investigate the effects of exogenous electric currents on cyclic nuclotide levels in feline alveolar bone and the possible clinical application of electric currents as an additional orthodontic tool. In the first study, three groups of three adult cats were subjected to application of a constant direct current of $10{\pm}2$ microamperes to gingival tissue near maxillary canine noninvasively for 1, 3, and 7 days respectively. In the second study, three groups of three adult cats each were treated by an electric-orthodontic procedure for 1, 3, and 7 days respectively. The left maxillary (control) canine received an orthodontic force of 80gm alone at time of initiation, while the right maxillary (experimental) canine received combined force-electric stimulation (80gm of force and $10{\pm}2$ microamperes of a constant D.C. currents). Alveola, bone samples were obtain from the mesial (tension and/or cathode) and the distal (compression and/or anode) sites surrounding maxillary canines as well as from contralateral control sites. The samples were extracted, boiled, homogenized, and the supernatants were assayed for cyclic nucleotides (cAMP, cGMP) by a radioimmunoassay method. And also the amount of tooth movement was measured in the second study. On the basis of this study, the following conclusions can be drawn: 1. The fluctuation pattern of cyclic nucleotide levels in alveolar bone treated by exogenous electric currents was similar to that treated by orthodontic force. 2. The cAMP levels in alveolar bone of electrically treated teeth significantly elevated above the control values. And of electrically treated teeth, the values of the anode sites were higher than those of the cathode sites. 9. The cGMP levels in alveolar bone of electrically treated teeth elevated above the control values at the initiation phase of treatment, but dropped below the control values at time of termination. And of electrically treated teeth, the values of the cathode sites were higher than those of the anode sites. 4. The rate of tooth movement in teeth . treated by force-electric combination increased with the length of treatment as compared to that treated by mechanical force alone.
The objective of this experiment is to observe structural differences in the othodontic movement of vital (control group) and devitalized (experimental group) teeth in the mongrel dogs. The 5 utilized dogs in this experiment were approximately 1 year of age and their average weight was about 12 Kg. Endodontic therapy was performed on the 2nd premolars in upper & lower jaws of each animal under the general anesthesia by intravascular injection of 25mg/kg of pentobarbital sodium. The canals of the teeth were obturated by using gutta percha in conjunction with root canal sealer (AH26 Densply). One of the roots in the 2nd premolars was hemisected to make an extraction space for the devitalized teeth to be moved. The edgewise technique was employed for the movement of the teeth. Orthodontic models and intraoral roentgenograms were taken before and after orthodontic tooth movement. The open coil springs (.010 x .040) were used at interbraket space in order to provide equal forces (75gm) between the teeth in each arch wire. After 13 weeks of active orthodontic tooth movement, dogs were sacrified and the experimental results w ere examined through the intraoral radiography, microscopic examination and scanning electromicroscopic examination at the root sulfate. From the results of the study, the following conclusions may be drawn: The root resolution and cemental deposition were observed within the pressure and tension site in both group. 2. The root resorbed lacunae were observed in the cementum and/or into the dentin in both group. 3. The prominent osteoblastic activities were observed on the alveolar margin in the tension site in both group. 4. A few of blood vessels were observed in the pressure site, but also lots of blood vessels were observed in the tension site especially in the periphery of the alveolar bone in both group. 5. In the pressure site, resorbed lacunae were formed with deep and narrow cavity in the control group; the shallow and wide cavity in the experimental group. 6. In the pressure site, the repaired cementum or cementoid tissue was lined on cementum in the experimental group, but not in the control group. 7. There was no significant difference between external root resolution of endodontically and vital teeth when both were subjected to orthodontic forces.
Papadopoulos, Nikolaos;Beindorff, Nicola;Hoffmann, Stefan;Jost-Brinkmann, Paul-Georg;Prager, Thomas Michael
The korean journal of orthodontics
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v.51
no.6
/
pp.366-374
/
2021
Objective: This study investigated the impact of a single piezocision in the maxillary alveolar process on the speed of tooth movement. The null hypothesis was that the speed of tooth movement will be equal with and without piezocision. Methods: All maxillary molars on one side were moved against the combined incisors in 10 ten-week-old male Wistar rats. Under general anesthesia, a force of 25 cN was applied on either side using a Sentalloy closed coil spring. After placing the orthodontic appliance, vertical corticision was performed using a piezotome under local anesthesia, 2 mm mesial from the mesial root of the first molar on a randomly selected side; the other side served as the control. At the beginning of the treatment, and 2 and 4 weeks later, skull micro-computed tomography was performed. After image reconstruction, the distance between the mesial root of the first molar and the incisive canal, and the length of the mesial root of the first maxillary molar were measured. Moreover, the root resorption score was determined as described by Lu et al. Results: Significantly higher speed of tooth movement was observed on the corticision side; thus, the null hypothesis was rejected. The loss of root length and root resorption score were significantly more pronounced after piezocision than before. A strong correlation was observed between the speed of tooth movement and root resorption on the surgical side, but the control side only showed a weak correlation. Conclusions: Piezocision accelerates orthodontic tooth movement and causes increased root resorption.
Objective: The aim of this study was to investigate and compare the in vivo effects of prostaglandin E2 (PGE2) administered by different methods on orthodontic tooth movement and bone metabolism macroscopically, histopatologically, and biochemically. Methods: Forty-five young adult New Zealand rabbits were randomly divided into 3 experimental groups (n = 10/group), 1 positive control group (n = 10), and 1 negative control group (n = 5). The experimental rabbits were fitted with springs exerting 20-g reciprocal force on the maxillary incisors and PGE2 (10 ${\mu}g/mL$) was administered by the intravenous, submucosal, or intra ligamentous route aft er appliance insertion and on days 1, 3, 7, and 14 thereafter. All rabbits were sacrificed on day 21 and their premaxillae were resected for histologic evaluation. Results: Tooth movement was observed in the experimental and positive control groups, but the intraligamentous PGE2 group had the highest values of all analyzed parameters, including serum calcium and phosphorus levels and osteoclastic and osteoblastic populations (p < 0.001). Conclusions: Sub mucosal and intraligamentous PGE2 administration significantly increases orthodontic tooth movement and bone metabolism, but the intraligamentous route seems to be more effective.
Kim, Kyong-Nim;Kim, Jue-Young;Cha, Jung-Yul;Choi, Sung-Hwan;Kim, Jin;Cho, Sung-Won;Hwang, Chung-Ju
The korean journal of orthodontics
/
v.50
no.6
/
pp.391-400
/
2020
Objective: Increased gingival elasticity has been implicated as the cause of relapse following orthodontic rotational tooth movement and approaches to reduce relapse are limited. This study aimed to investigate the effects of sulforaphane (SFN), an inhibitor of osteoclastogenesis, on gene expression in gingival fibroblasts and relapse after rotational tooth movement in beagle dogs. Methods: The lower lateral incisors of five beagle dogs were rotated. SFN or dimethylsulfoxide (DMSO) were injected into the supra-alveolar gingiva of the experimental and control group, respectively, and the effect of SFN on relapse tendency was evaluated. Changes in mRNA expression of extracellular matrix components associated with gingival elasticity in beagles were investigated by real-time polymerase chain reaction. Morphology and arrangement of collagen fibers were observed on Masson's trichrome staining of buccal gingival tissues of experimental and control teeth. Results: SFN reduced the amount and percentage of relapse of orthodontic rotation. It also decreased the gene expression of lysyl oxidase and increased the gene expression of matrix metalloproteinase (MMP) 1 and MMP 12, compared with DMSO control subjects. Histologically, collagen fiber bundles were arranged irregularly and were not well connected in the SFN-treated group, whereas the fibers extended in parallel and perpendicular directions toward the gingiva and alveolar bone in a more regular and well-ordered arrangement in the DMSO-treated group. Conclusions: Our findings demonstrated that SFN treatment may be a promising pharmacologic approach to prevent orthodontic rotational relapse caused by increased gingival elasticity of rotated teeth in beagle dogs.
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