art-Ciur-178-181
ORTHODONTICS
ALTERNATIVE METHODS FOR ACCELERATING THE RATE OF ORTHODONTIC
Review Articles
TOOTH MOVEMENT: LITERATURE REVIEW
Maria-Dumitrela Ciur1a , Raluca-Maria Vieriu1b* , Nicolae Daniel Olteanu1c* , Liviu Zetu2d , Irina Nicoleta Zetu1e
1
Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Medicine, “Grigore T. Popa”University of Pharmacy, Iași, Romania
2
Department of Odontology and Periodontology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania
a
DM, PhD, Private practice
b
DMD, PhD, Assistant professor
c
DMD, PhD student, Assistant professor
d
DMD, PhD, Lecturer
e
DMD, PhD, Professor
ABSTRACT DOI: https://doi.org/10.25241/stomaeduj.2019.6(3).art.3 OPEN ACCESS This is an Open Access
article under the CC BY-NC 4.0 license.
Background: The rate of orthodontic tooth movement depends on two general
factors: the forces used in order to cause orthodontic tooth movement and Peer-Reviewed Article
respectively the individual (biological) response of the body to these forces. Citation: Ciur M-D, Vieriu R-M, Olteanu ND, Zetu L,
Zetu IN. Alternative methods for accelerating the rate
Objective: The aim of this review is to offer an overview of the factors that has of orthodontic tooth movement: literature review.
been mentioned in literature to accelerate the biologic response to orthodontic Stoma Edu J. 2019;6(3):178-181.
forces. Received: July 29, 2019
Revised: August 14, 2019
Data Sources: PubMed, Google Scholar and Scopus databases were used. Accepted: September 26, 2019
Study selection: We included in our study controlled clinical trials, but also Published: September 27, 2019
randomized controlled trials and even cases series with more than 5 subjects that *Corresponding author:
Raluca-Maria Vieriu, DMD, PhD, Assistant professor
aimed to evaluate alternatives methods in accelerating the rate of orthodontic 16 University Street, Iași, Romania
tooth movement. Publications published until April 2018 were included. Tel.:/Fax: +40745456640,
e-mail: vieriu.ralucamaria@gmail.com
Data Extraction: All the factors that had been mentioned in literature to have a Nicolae Daniel Olteanu, DMD, PhD student,
Assistant professor
positive influence on the rate of orthodontic tooth movement were synthesized 16 University Street, Iași, Romania
and described as a review. These methods are the followings: physical, surgical Tel.:/Fax: +40744606655,
e-mail: danielolteanund@gmail.com
and chemical agents. Physical factors are easy to apply, surgical factors are invasive
Copyright: © 2019 the Editorial Council for the
and the pharmacological agents we described in this article are: prostaglandin E2 Stomatology Edu Journal.
(PGE2) and vitamin D3.
Data Synthesis: The alternatives methods that accelerate the rate of orthodontic
tooth movement modulate the biologic response of the periodontal ligament to
the mechanical forces. Vitamin D3 was mentioned as the most biopotent agent
in accelerating the rate of orthodontic treatment. Although it has biomodulator
effect on bone tissue, supplementary studies are needed in order to clarify what is
the exact reduction of orthodontic treatment period.
Keywords: Accelerated orthodontic tooth movement; Rate of orthodontic tooth
movement; Orthodontic treatment; Biologic response.
1. Introduction are applied on the tooth, the resorption process is
Recently, it has been mentioned in literature many directly influenced by the number of the recruited
methods for accelerating the rate of orthodontic osteoclasts in the local area [1].
tooth movement. The rate of orthodontic tooth Secondary, the cell response of the body to
movement depends on the forces used in order orthodontic tooth movement can be accelerated by
to cause orthodontic tooth movement and the many factors.
individual response (the biological response) of the The aim of this article was to update the information
body to these forces. mentioned in literature regarding the possibilities to
Regarding the optimal forces used in order to accelerate orthodontic tooth movement.
determine the orthodontic tooth movement,
Schwarz established that the forces used to move the 2. Methodology
teeth must be equal to the capillary pressure on the A literature search in PubMed, Google Scholar and
periodontal ligament. The forces situated below this Scopus databases was performed in order the find
threshold do not cause any tooth movement, while randomized controlled trials, controlled clinical trials,
the forces that exceed this level cause avascular clinical cases with at least 5 subjects that aimed to
area on the periodontal ligament. While the forces evaluate the alternatives methods that accelerate the
178 Stoma Edu J. 2019;6(3): 178-181. http://www.stomaeduj.com
ALTERNATIVE METHODS FOR ACCELERATING THE RATE OF ORTHODONTIC
TOOTH MOVEMENT: LITERATURE REVIEW
rate of orthodontic tooth movement. Publications process. Their effect on the rate of orthodontic tooth
Review Articles
published until April 2018 were included. We used movement was studied by various researchers using
the following keywords: (drugs OR medicaments OR animals like monkeys or rats [5-8]. The results of their
pharmacological agents OR vibratory stimulation studies shown that experimental tooth movement
OR surgical methods) and (accelerated orthodontic was greater compared with the rate of control
tooth movement OR increased orthodontic tooth tooth after one single application or after multiple
movement). The factors that can influence positively application, the rate of the tooth movement of
the rate of orthodontic tooth movement are the experimental tooth being depended of the
presented in a form of literature review. administrated dose of PGE2 [5-8]. The action
mechanism of the PGE2 is explained through the
3. Results stimulation process of bone resorption acting
3.1. Physical stimuli directly on osteoclastic cells [9].
Physical stimuli used in association with active Vitamin D3 (calcitriol or 1,25 dihidroxicolecalciferol)
orthodontic tooth movement in order to accelerate is the active form of the vitamin D which is formed
the rate of orthodontic tooth movement are the on dermis or it is obtained from alimentary sources
following: photobiomodulation, low level laser and after the two hydroxylation on the liver and
therapy, low frequency electromagnetic fields, kidney respectively convert into the active form of
vibrations, low-intensity pulsed ultrasound. vitamin D3 (calcitriol or 1,25 dihidroxicolecalciferol).
Low level laser therapy and low-intensity pulsed Vitamin D3 in association with calcitonin and parotid
ultrasound were used in order to accelerate hormone are implicated in regulation of the fosfo-
orthodontic tooth movement because they calcic homeostasis. Moreover, vitamin D3 in its active
have bio-stimulatory effects [2]. In cell-culture form stimulates bone apposition and it has been
experiments, it has been shown that low-intensity shown that vitamin D receptors present both the
pulsed ultrasound application cause an effect on osteoblastic and osteoclastic cells [8].
osteoblastic cells. These osteoblastic cells respond Studies in vivo shown an augmentation of
by producing local factors: bone morphogenetic orthodontic tooth movement after local
proteins (BMP), growth factors (FGF, TGF-beta), administration of vitamin D3 [10,11,12]. These
and cytokines (IL). These local factors trigger new augmentations is related to both the role of the
osteoblastic cells. Also, it has been shown that low- vitamin D3 in inducing osteoblastic cells proliferation
intensity pulsed ultrasound application has an effect [13] and stimulating osteoclastic cells activity [13].
on osteoclastic cells in cell-culture experiments. The rate of orthodontic tooth movement for the
Moreover, the studies that were done on animals, experimental tooth was 60% greater than the rate of
shown that the application of low-intensity pulsed orthodontic tooth movement measured on control
ultrasound caused an acceleration of the process tooth.
that lead to new bone formation. Humans studies that demonstrate the clinically
The pulsed electromagnetic fields (PEMFs) efficiency of locally administration of calcitriol
application influence bone metabolism [3]. Several in acceleration the rate of orthodontic tooth
studies demonstrated that electromagnetic fields movement are reduced and inconclusive. In this
accelerate the bone formation. regard, the only article one humans which evaluates
3.2. Surgical procedures the clinical efficacy of locally administrated calcitriol
Several surgical procedures were performed in in accelerating the rate of orthodontic tooth
order to reduce the rate of orthodontic treatment: movement is the article published by Al Hasani et
corticotomy, dental distraction, piezocision, section al in 2011. The results of their study shown a rate
of the periodontal ligament. of tooth movement grater with a percentage equal
Alternatives methods used in association with of 51% for the experimental tooth compared to the
conventional orthodontic therapy cause an controls tooth [14].
augmentation of the rate of orthodontic tooth The association of alternatives methods with
movement compared with orthodontic treatment conventional orthodontic therapy benefits of some
only. This phenomenon is related to the effect of advantages like: accelerated tooth movement,
stimulation of bone turnover and also to accelerated reduced treatment period time and even greater
cellular activity in the periodontal ligament [4]. stability of the results obtained after orthodontic
3.3. Pharmacological agents treatment. Physical stimuli are easy the applicate
Regarding the pharmacological agents that but necessitate special devices. Surgical procedures
contribute to the acceleration of the rate of determine rapid tooth movements, but are invasive
orthodontic treatment mentioned in literature methods. As regarding the pharmacological
we cite: PGE2, vitamin D, parotid hormone, and agents, they are easy to administrate. Of all the
thyroxine. pharmacological agents mentioned in this article,
Prostaglandin E2 (PGE2) is one of the most studied locally administration of calcitriol is the promisive way
pharmacological agent implicated in bone turnover to reduce orthodontic treatment time. Vitamin D3 in
which has an important role in the inflammatory its active biological form has several benefits when
Stomatology Edu Journal 179
ALTERNATIVE METHODS FOR ACCELERATING THE RATE OF ORTHODONTIC
TOOTH MOVEMENT: LITERATURE REVIEW
is locally administrated: stimulates bone resorption seems to be the most promisive way to accelerate
Review Articles inherent for any therapeutic tooth movement and the orthodontic treatment: it is an easy method to
promote bone apposition, helping optimizing the realize, it has no secondary effect. Although the
ratio between resorption and apposition in the results of previous study mentioned its important
periodontal ligament. In this way, the biological role in the biology of orthodontic tooth movement,
response to the biomechanical forces is optimized. the information regarding the overall reduced
Other agents, like prostaglandin E2 has an important treatment period are absents. It will be interesting
effect in accelerating orthodontic tooth movement studying the amount of reduced orthodontic
even when it is administrated on a single dose mode, treatment period caused by locally administration of
but it has also a secondary effects, being responsible vitamin D3 and comparing this period to the one in
for inducing root resorption on experimental tooth. which patients are following orthodontic treatment
That’s why the studies were reduced only to animals only.
and were not been extended to humans beings.
Conflict of interest statement
4. Limitations of the current analysis The authors declare no conflict of interest.
The articles that met the inclusion criteria were few
because the randomized controlled trials, controlled Author Contributions
clinical trials and respectively clinical cases with more MDC, OND, LZ: wrote the manuscript. RMV, INZ:
than 5 subjects included that aimed to accelerate critically revised the manuscript.
the orthodontic tooth movement are few.
5. Conclusions
Of all the alternatives methods presented in this
article, locally administrated calcitriol (vitamin D3)
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180 Stoma Edu J. 2019;6(3): 178-181. http://www.stomaeduj.com
ALTERNATIVE METHODS FOR ACCELERATING THE RATE OF ORTHODONTIC
TOOTH MOVEMENT: LITERATURE REVIEW
Review Articles
Maria-Dumitrela CIUR
DMD, PhD, Researcher
Department of Orhtodontics and Dento-Facial Orthopaedics
Faculty of Dental Medicine “Grigore T. Popa” University of Pharmacy and Medicine
Iași, Romania
CV
Maria-Dumitrela Ciur is researcher in the field of Medicine and specialist in Orhtodontics and Dento-Facial Orthopaedics at the
Faculty of Dental Medicine, “Grigore T. Popa” University of Pharmacy and Medicine, Iași, Romania. She became a PhD Student
in 2012 at the Department of Odontology-Periodontology and Department of Normal and Pathological Physiology, “Grigore T.
Popa” University of Pharmacy and Medicine, Iași, Romania. She studied four months at University Claude Bernard Lyon 1. She
became specialist in Orthodontics and Dentofacial Orthopedics in 2016 and Doctor of Medicine in 2017. For the moment, she
practice in private dental medicine.
Questions
1. The most biopotent agent in accelerating the rate of orthodontic treatment is:
qa. Vitamin D3;
qb. Vitamin C;
qc. Vitamin D;
qd. Vitamin A.
2. The surgical procedures performed in order to reduce the rate of orthodontic
treatment are the folllowing, with one exception:
qa. Corticotomy;
qb. Administration of calcium;
qc. Piezocision;
qd. Dental distraction.
3. The pharmacological agents that contribute to the acceleration of the rate of
orthodontic treatment are folllowing, with one exception:
qa. PGE2;
qb. Vitamine D;
qc. Vitamin B;
qd. Parotid hormone.
4. The association of alternatives methods with conventional orthodontic therapy
benefits have the following advantages, with one exception:
qa. Increased treatment period time;
qb. Accelerated tooth movement;
qc. Reduced treatment period time;
qd. Greater stability of the results obtained after orthodontic treatment.
www.ortodonti2019.org
Stomatology Edu Journal 181