/home/opencode/cpanel/stomaeduj_hacked/uploads/2019/10/art-Ciur-178-181.pdf 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) References 1. Zetu IN, Zetu L. Contention. In: Matei S, Stan E, editors. 9. Seifi M, Eslami B, Saffar AS. The effect of prostaglandin E2 [Orthodontics and straight wire technique]. Second edition. [in and calcium gluconate on orthodontic tooth movement Romanian]. Târgu Mureș, RO: Publishing House Lyra; 2003. and root resorption in rats. Eur J Orthod. 2003;25(2):199-204. 2. Xue H, Zheng J, Cui Z, et al. 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[CrossRef ] [PubMed] Google Scholar Scopus 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