Biological Mechanisms of Tooth Movement

Biological Mechanisms of Tooth Movement
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This new edition continues to be an authoritative reference to the scientific foundations underpinning clinical orthodontics The newly and thoroughly revised Third Edition of Biological Mechanisms of Tooth Movement delivers a comprehensive reference for orthodontic trainees and specialists. It is fully updated to include new chapters on personalized orthodontics as well as the inflammatory process occurring in the dental and paradental tissues. It is heavily illustrated throughout, making it easier for readers to understand and retain the information discussed within. The topics covered range from bone biology, the effects of mechanical loading on tissues and cells, genetics, tissue remodeling, and the effects of diet, drugs, and systemic diseases. The Third Edition of Biological Mechanisms of Tooth Movement features seven sections that cover subjects such as: The development of biological concepts in orthodontics, including the cellular and molecular biology behind orthodontic tooth movement Mechanics meets biology, including the effects of mechanical loading on hard and soft tissues and cells, and biological reactions to temporary anchorage devices Inflammation and orthodontics, including markers for tissue remodeling in the gingival crevicular fluid and saliva Personalized diagnosis and treatment based on genomic criteria, including the genetic influences on orthodontic tooth movement Rapid orthodontics, including methods to accelerate or decelerate orthodontic tooth movement Perfect for residents and PhD students of orthodontic and periodontal programs, Biological Mechanisms of Tooth Movement is also useful to academics, clinicians, bone biologists, and researchers with an interest in the mechanics and biology of tooth movement.

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Группа авторов. Biological Mechanisms of Tooth Movement

Table of Contents

List of Tables

List of Illustrations

Guide

Pages

Biological Mechanisms of Tooth Movement

Contributors

Preface to the First Edition

Preface to the Second Edition

Preface to the Third Edition

CHAPTER 1 Biological Basis of Orthodontic Tooth Movement: A Historical Perspective

Summary

Introduction

Orthodontic treatment in the ancient world, the Middle Ages, and through the Renaissance period: Mechanics, but few biological considerations

Orthodontic treatment during the Industrial Revolution: Emergence of identification of biological factors

Orthodontic tooth movement in the twentieth and twenty‐first centuries: From light microscopy to tissue engineering and stem cells. Histological studies of paradental tissues during tooth movement

Histochemical evaluation of the tissue response to applied mechanical loads

The era of cellular and molecular biology as major determinants of orthodontic treatment

Conclusions and the road ahead

References

CHAPTER 2 Biology of Orthodontic Tooth Movement: The Evolution of Hypotheses and Concepts

Summary

Introduction

Hypotheses about the biological nature of OTM: The conceptual evolution

Walkhoff’s hypothesis on the biology of OTM

Oppenheim’s transformation hypothesis

The pressure–tension hypothesis

The fluid dynamic hypothesis

The bone‐bending hypothesis

Bioelectric signals in orthodontic tooth movement

Concluding remarks

References

CHAPTER 3 Cellular and Molecular Biology of Orthodontic Tooth Movement

Summary

Introduction

Entities important for tooth movement – the players in the game. Extracellular matrix

Cells

Biomechanical characteristics of the PDL

General regulatory mechanisms. Cell–cell interactions

Cell–matrix interactions

Effects of orthodontic force application. Phases of OTM

Cell biological processes during initial phase and hyalinization

Cell biological processes during real tooth movement

Cell biological processes during relapse and retention

Conclusions

References

CHAPTER 4 Inflammatory Response in the Periodontal Ligament and Dental Pulp During Orthodontic Tooth Movement

Summary

Introduction

Inflammation during tooth movement

Inflammatory mediators in OTM

DAMPs

Prostaglandins

The second‐messenger system

Cytokines

Interleukins

TNF and the RANK/RANKL/OPG system

The chemokine system

Growth factors

Matrix metalloproteinases (MMPs)

Neuropeptides

Substance P and neurokinin A

Calcitonin gene‐related peptide

Vasoactive intestinal polypeptide

Neuropeptide Y

Neuropeptides and OTM: A synthesis

Activation of inflammation, apoptosis, and cell cycles of PDL in OTM

Response of the dental pulp to mechanical forces

Neuropeptide response in dental pulp to orthodontic force

Vasodilatation and angiogenesis response to orthodontic forces

Pain during OTM

Root resorption and inflammation

Root resorption in the cementum

Conclusions

References

CHAPTER 5 The Effects of Mechanical Loading on Hard and Soft Tissues and Cells

Summary

Introduction

Mechanobiology

Mechanotransduction in bone tissue

Mechanotransduction in periodontal tissues

The role of marginal gingiva in orthodontic tooth movement

Marginal gingiva is the mechanosensor of the periodontium

ATP‐purinoreceptors are mechanosensors in marginal gingiva

Conclusions

Acknowledgement

References

CHAPTER 6 Biological Aspects of Bone Growth and Metabolism in Orthodontics

Summary

Introduction

Basic concepts of bone growth and development

Bone formation

Endochondral bone formation

Intramembranous bone formation

Primary growth centers and sites in facial bones

Bone modeling and remodeling

Genetic mechanisms for environment adaptation

Genetic determinants of overall craniofacial growth

Vascular invasion

Inflammatory response

Cellular agents

Factors influencing bone remodeling and modeling. Coupling of bone formation to resorption in bone remodeling

Metabolic control of bone remodeling

Mechanical control of bone remodeling

Mechanical aspects of bone modeling

Bone modeling/remodeling, tooth movement, and external apical root resorption

Cortical bone remodeling

Trabecular bone remodeling

Growth and development of facial bones

Temporomandibular joint development and mature adaptation

Tooth movement and bone modeling

Dental facial orthopedics and bone modeling

Calcium metabolism and tooth movement

Conclusion

Acknowledgement

References

CHAPTER 7 Mechanical Load, Sex Hormones, and Bone Modeling

Summary

Introduction

Osteoblast/osteocyte differentiation and function. Osteoblast differentiation

Osteoblasts as bone‐forming cells

Osteoblasts as regulators of osteoclast formation

Osteocytes

Osteocytes as bone‐remodeling cells

Osteocytes as mechano‐sensory cells

Osteoclast differentiation and function

Osteoclast differentiation

Osteoclast function

Osteoclast‐dependent factors important for osteoblast stimulation during bone remodeling

Sex hormones and their receptors

Genomic signaling through sex‐hormone receptors in bone

Non‐genomic signaling by sex‐hormone receptors

Osteoblasts and osteocytes respond to load‐induced modeling

Wnt/ β ‐catenin pathway

IGF‐1 pathway

Nitric oxide signaling

Prostaglandin pathway

Loading‐induced anabolic response and vitamin A

Osteoclast response to load‐induced modeling

Role of sex hormones for the osteogenic effect of loading. Male sex hormones and loading

Female sex hormones and loading

Sex hormones and OTM

Acknowledgements

References

CHAPTER 8 Biological Reactions to Temporary Anchorage Devices

Summary

Introduction

Clinical factors in the success of TADs

Age of the patient

Loading time point

Implantation site

Insertion torque

Implant diameter and length

Mobility

Mechanical analysis using finite element models

Cortical bone thickness

Insertion angulations

Thread location, properties, and mechanical anisotropy

Exposed length

Histological reactions

Osseointegration process

Immediate loading of orthodontic miniscrews

Time point of loading

The diameter ratio of pilot hole to miniscrew

Inflammatory reactions

Conclusions

References

CHAPTER 9 Tissue Reaction to Orthodontic Force Systems. Are we in Control?

Summary

Introduction

Pressure–tension theory: Still valid?

The influence of the material properties

The influence of the morphology of the alveolar wall

The influence of force level

The influence of the interaction with occlusion

Conclusions

Where are we now? How should we continue?

References

CHAPTER 10 The Influence of Orthodontic Treatment on Oral Microbiology

Summary

Introduction

Microbiology of periodontal disease

Microbiology of dental caries

Changes in the oral microbiome with removable orthodontic appliances

Periodontal bacteria

Cariogenic bacteria

Fungi

Changes in the oral microbiome with fixed orthodontic appliances

Periodontal bacteria

Cariogenic bacteria

Fungi

Effects of different orthodontic bracket types on oral microbiome. Conventional brackets

Self‐ligating brackets

Lingual brackets

Conventional metallic versus aesthetic brackets (composite or ceramic)

Changes in the oral microbiome with orthodontic retainers. Removable orthodontic retainers. Cariogenic bacteria

Periodontal bacteria

Fungi

Fixed orthodontic retainers. Cariogenic bacteria

Periodontal bacteria

Importance of oral hygiene

Impacted teeth, mini‐implants, orthognathic surgery and changes in oral microbiota. Impacted teeth

Mini‐implants

Orthognathic surgery

Conclusions

References

CHAPTER 11 Markers of Paradental Tissue Remodeling in the Gingival Crevicular Fluid and Saliva of Orthodontic Patients

Summary

Why study oral fluids?

What is known about markers in oral fluids during orthodontic tooth movement?

Saliva studies

GCF studies

What is needed for improved diagnostic trials of markers in oral fluids during orthodontic treatment?

Variables associated with the collection and analysis of GCF. GCF collection during orthodontic therapy

Methods of collection

Quantification of GCF constituents

Outcomes associated with orthodontic treatment

The future

Conclusions

References

CHAPTER 12 Genetic Influences on Orthodontic Tooth Movement

Summary

Introduction

Tissue reactions to application of mechanical forces. Reaction of the periodontal ligament

How do changes in the PDL affect tissues?

Reaction of neural tissues

Reaction of the alveolar bone

Gene expression and osteoclasts

Gene expression and osteoblasts/osteocytes

Bone remodeling

Role of growth factors in bone remodeling

Reaction of the pulp tissues

Genetic influences and translational applications

Complications of OTM and its genetic implications

Eruption failure/primary failure of eruption

Tooth relapse

Root resorption

Conclusions

References

CHAPTER 13 Precision Orthodontics: Limitations and Possibilities in Practice

Summary

Introduction. Definition

Evidence‐based guidelines practice versus precision medicine practice

Progression in DNA analysis technology and its impact on clinical research and practice. The Human Genome Project

Genome‐wide association studies (GWAS)

Next‐generation sequencing

Human phenotype ontology

Application in medical practice

Efficacy of risk prediction of Mendelian (single‐gene) versus complex traits

Precision oral healthcare

From personalized to precision orthodontics

Class III malocclusion

External apical root resorption concurrent with orthodontia

Sagittal facial growth during puberty

Primary failure of eruption

Support of next generation sequencing, other genetic studies, and the utility of their application in orthodontics

Education

Conclusion

References

CHAPTER 14 The Effect of Drugs, Hormones, and Diet on Orthodontic Tooth Movement

Summary

Introduction

Prostaglandins and analogues

Implication

Nonsteroidal anti‐inflammatory drugs

Implication

Antiresorptive agents

Implication

Asthma medications

Implication

Corticosteroids

Implication

Antihistamines

Implication

Statins: cholesterol‐lowering drugs

Implication

Drugs inducing gingival enlargement

Implication

Anticholinergic drugs

Implication

Psychiatric drugs

Implication

Hormonal influences on tooth movement. Thyroid hormones

Implication

Parathyroid hormone and analogues

Implication

Growth hormone

Implication

Estrogen

Implication

Relaxin

Implication

Effects of vitamins, minerals, and diet on tooth movement

Vitamins

Vitamin C

Implication

Vitamin D

Implication

Vitamin A

Implication

Minerals

Implication

Fluoride

Implication

Lipids

Implication

Substance abuse and OTM. Alcohol use

Implication

Nicotine use

Implication

Conclusions

References

CHAPTER 15 Biological Orthodontics: Methods to Accelerate or Decelerate Orthodontic Tooth Movement

Summary

Introduction

Early attempts to accelerate tooth movement

Accelerating tooth movement: pharmacological approaches. Local cytokine delivery

Prostaglandins

RANKL

Hormones promoting tooth movement. Parathyroid hormone

1,25‐Dihydroxycholecalciferol (1,25‐(OH)2D3) (Vitamin D3)

Relaxin

Corticosteroids

Conclusion

Accelerating tooth movement: physical stimuli. Direct electric currents and pulsed electromagnetic fields

Vibratory stimulus

Photobiomodulation

Low‐level laser therapy

Light emitting diode (LED) therapy

Surgical approaches

Methods to decelerate tooth movement. Drugs

Local MMP inhibitors and osteoprotegerin transfer

Estrogen

Conclusions

References

CHAPTER 16 Surgically Assisted Tooth Movement: Biological Application

Summary

Introduction

Surgically assisted tooth movement

Biological principles and biomechanical considerations. The regional acceleratory phenomenon

Finite element analysis of surgically assisted tooth movement

Historical background

A different perspective: six rules for effective alveolar corticotomy

1. Alveolar corticotomy is to facilitate OTM

2. Alveolar corticotomy has a limited effect in time

3. Alveolar corticotomy has limited effects in space

4. Alveolar corticotomy needs a proper surgical protocol

The open flap corticotomy and grafting

The flapless corticotomy

5. Alveolar corticotomy needs correct orthodontic management postsurgery

6. Alveolar corticotomy needs a proper selection of patients

Clinical examples

Patient 1 (Figure 16.22)

Patient 2 (Figure 16.23)

Patient 3 (Figure 16.24)

Patient 4 (Figure 16.25)

Patient 5 (Figure 16.26)

Patient 6 (Figure 16.27)

Patient 7 (Figure 16.28)

Patient 8 (Figure 16.29)

Conclusions

References

CHAPTER 17 Precision Accelerated Orthodontics: How Micro‐osteoperforations and Vibration Trigger Inflammation to Optimize Tooth Movement

Summary

Introduction

Sculpting biphasic theory from the bedrock of data

Saturation of the biological response: more does not mean faster

MOPs: hyperlocalized inflammation for safe, minimally invasive accelerated tooth movement

Clinical considerations for MOPs application

1. Accelerate the movement of target teeth

2. Facilitate the desired type of tooth movement

3. Develop biological anchorage

4. Decrease the possibility of root resorption

5. Moving teeth through atrophic bone

Good vibrations: catabolic response during OTM

Conclusion

References

CHAPTER 18 Mechanical and Biological Determinants of Iatrogenic Injuries in Orthodontics

Summary

Introduction

Intraoral iatrogenic effects

Gingival effects

Clinically visible changes

Histological and microbiologic changes

Periodontal changes and alveolar bone loss

Tooth‐related changes

Enamel decalcification and trauma

Pulpal reactions

Root resorption

Soft tissue irritation

Cytotoxicity and allergic reactions

Extraoral iatrogenic effects. Allergy

Extraoral injuries

Burns

Systemic risks. Cross infection

Pain

Swallowing or inhalation of small parts

Conclusions

References

CHAPTER 19 The Biological Background of Relapse of Orthodontic Tooth Movement

SUMMARY

Introduction

Relapse, physiologic recovery, or aging?

The process of relapse. Amount, rate, and duration

Effect of retention

Histological changes during relapse

Collagen fibers of the periodontium and relapse. Terminology

Collagen fibers and relapse after translational tooth movement

Collagen fibers and relapse after rotational tooth movement

Collagen fibers and relapse after closure of extraction space or midline diastema

Turnover of collagen in the periodontium

Biological techniques affecting orthodontic relapse

Oxytalan fibers

Conclusions

References

CHAPTER 20 Planning and Executing Tooth‐movement Research

Summary

Introduction

The scientific method

Evidence generation

Laboratory studies in orthodontic biologic research – in vitro versus ex vivo studies

Cell culture methods

Media preparation, trypsinization, and cell culturing

Animal models

Studies in humans

Methodologies for tooth‐movement research

Tissue level/cellular level studies. Histological studies

Immunohistochemistry

Immunocytochemistry

Flow cytometry

Techniques for genomic studies

Polymerase chain reaction

RT‐PCR versus qPCR

DNA microarray

ChIP assay

Electrophoretic mobility shift assay (EMSA)

Proteomic analysis/cytoplasm‐level studies. Enzyme‐linked immunosorbent assay (ELISA)

Western‐blot analysis

Protein microarray

Toxicology studies. MTT assay

Micronucleus assay

Single cell gel electrophoresis (comet assay)

DNA laddering

Studying mechanobiology

Atomic force microscopy

Magnetic twisting cytometry

Magnetic pulling cytometry

Micropipette aspiration

Laser‐tracking microrheology

Traction force microscopy

Microfabrication

Microfluidics

Conclusions

References

CHAPTER 21 Controversies and Research Directions in Tooth‐movement Research

Summary

Introduction

The optimal orthodontic force concept

Is tooth movement inflammatory or a mechanotransduction process?

How far are biomarkers useful in validating OTM?

Can we accelerate tooth movement by any means?

Alveolar bone density and shape of the alveolar wall

Gingival recession

Periodontal health

Conclusions

References

Index

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Another outlook on differential orthodontic forces was proposed by Storey (1973). Based upon experiments in rodents, he classified orthodontic forces as being bioelastic, bioplastic, and biodisruptive, moving from light to heavy. He also reported that in all categories, some tissue damage must occur in order to promote a cellular response, and that inflammation starts in paradental tissues right after the application of orthodontic forces.

Continuing the legacy of Sandstedt, Kvam and Rygh studied cellular reactions in the compression side of the PDL. Rygh (1974, 1976) reported on ultrastructural changes in blood vessels in both human and rat material as packing of erythrocytes in dilated blood vessels within 30 minutes, fragmentation of erythrocytes after 2–3 hours, and disintegration of blood vessel walls and extravasation of their contents after 1–7 days. He also observed necrotic changes in PDL fibroblasts, including dilatation of the endoplasmic reticulum and mitochondrial swelling within 30 minutes, followed by rupture of the cell membrane and nuclear fragmentation after 2 hours; cellular and nuclear fragments remained within hyalinized zones for several days. Root resorption associated with the removal of the hyalinized tissue was reported by Kvam and Rygh. This occurrence was confirmed by a scanning electron microscopic study of premolar root surfaces after application of a 50 g force in a lateral direction (Kvam, 1972). Using transmission electron microscopy (TEM), the participation of blood‐borne cells in the remodeling of the mechanically stressed PDL was confirmed by Rygh and Selvig (1973), and Rygh (1974, 1976). In rodents, they detected macrophages at the edge of the hyalinized zone, invading the necrotic PDL, phagocytizing its cellular debris and strained matrix.

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