Effects of tooth loading on the periodontal vasculature of the mandibular fourth premolar in dogs

Movement analysis of primate molar teeth under load using synchrotron X-ray microtomography

Mammalian teeth have to sustain repetitive and high chewing loads without failure. Key to this capability is the periodontal ligament (PDL), a connective tissue containing a collagenous fibre network which connects the tooth roots to the alveolar bone socket and which allows the teeth to move when loaded. It has been suggested that rodent molars under load experience a screw-like downward motion but it remains unclear whether this movement also occurs in primates. Here we use synchroton micro-computed tomography paired with an axial loading setup to investigate the form-function relationship between tooth movement and the morphology of the PDL space in a non-human primate, the mouse lemur (Microcebus murinus). The loading behavior of both mandibular and maxillary molars showed a three-dimensional movement with translational and rotational components, which pushes the tooth into the alveolar socket. Moreover, we found a non-uniform PDL thickness distribution and a gradual increase in volumetric proportion of the periodontal vasculature from cervical to apical. Our results suggest that the PDL morphology may optimize the three-dimensional tooth movement to avoid high stresses under loading.

Evaluation of proximal contact strength by postural changes

STATEMENT OF PROBLEM

Proper proximal contact is important for maintaining and stabilizing the dental arch. However, the proximal contact strength (PCS) is not a constant value and can be affected by a variety of factors.

PURPOSE

This study examined the influences of postural changes on the posterior PCS.

MATERIAL AND METHODS

Twelve adults with a normal occlusion and had not undergone prosthetic treatment or proximal restoration were participated in this study. A metal strip was inserted into the proximal surface and removed at a constant velocity. The contact strength was measured in every contact point between canine to second molar in both arches. The PCSs were obtained initially in the upright position, secondly in the supine position and finally in the upright position again. All measurements were repeated after a 2 hour period. Statistical analysis was carried out using the Friedman test (P < .05).

RESULTS

Generally, a decrease in PCS occurred when the posture was changed from the initial upright to supine position, while it increased when the posture was changed from the supine to upright position. A significant change was observed in all areas except for between the canine-first premolar in the maxilla and between the first molarsecond molar in the mandible areas.

CONCLUSION

The posterior PCS, which dentists generally believe to be a static feature of occlusion, is affected significantly by posture.

Effect of duration of force application on blood vessels in young and adult rats

INTRODUCTION

Age effects on orthodontically induced periodontal vascular reactions have not been studied. The aim of the present study was to test the hypothesis that prolonged tooth movement induces age-related increases in periodontal vascularity.

METHODS

A standardized orthodontic appliance was placed in 2 groups of 30 rats aged 6 weeks and 9 to 12 months. At 1, 2, 4, 8, and 12 weeks, animals were killed. Blood vessels (BV) were identified based on their morphology and by immunohistochemical staining for alpha-smooth muscle actin. At each study region, surface areas (SA) of the periodontal ligament space and each BV were measured; BV mean SA, BV relative SA (the summed BV SA as a percentage of the periodontal ligament SA), and BV numbers were calculated.

RESULTS

Pressure and tension regions showed similar vascular changes. Young rats had lower BV relative SA and BV mean SA in the early phase of force application (< 4 weeks); this increased in the late phase, reaching the same level as adult rats. In the late phase (4-12 weeks), young rats had increases of both small- and large-sized BV that did not affect the BV mean SA; adult rats had an increase of small-sized BV only; this resulted in decreased BV mean SA.

CONCLUSIONS

The hypothesis was confirmed that prolonged tooth movement increases periodontal vascularity, which is age related. These results suggest that clinicians should consider age-related difference in tissue reactions during orthodontic tooth movement.

Mechanical characterization of bovine periodontal ligament

This study is part of a research program that aims to develop a constitutive three-dimensional model of the periodontal ligament (PDL) through the identification of pertinent material parameters. As part of this program, bovine PDL was utilized to establish stress-strain responses under tensile and compressive loading conditions. Fresh bovine molars were secured, frozen and prepared to appropriate dimensional specifications. Bar-shaped specimens that comprised portions of dentine, PDL and bone were produced. Push-pull tests were conducted using a specifically constructed loading machine. Full range monotonic stress-strain diagrams were generated. The effect of a rate increase on cyclic S-E diagrams was also determined. The influence of specimen thickness was expressed in terms of modulus of elasticity, strength, uniaxial maximizer strain, and strain energy density. The overall load-response was heavily hysteretic in compression. On the tensile side, after a steep rise, the curve tended to flatten out asymptotically. Variations in rate that spanned four orders of magnitude had no effect on reciprocal load responses. The E-modulus was in the 4-8 MPa range, the strength of the PDL was 1-2 MPa, the maximizer strain was at 45-60% and the strain energy density ranged between 0.3 and 0.4 MPa.

Histomorphometric study of the periodontal vasculature during and after experimental tipping of the rat incisor

The periodontal vasculature encircling the entire length of the rat lower incisor was studied at the time of tipping movement and 3 months later. In 12 rats (212+/-4 g b.w.), loads (0.19+/-0.016 N) were applied to the lower left incisor in a linguointrusive direction. After 2 weeks of loading, six experimental animals were killed with the loading springs in place. The springs were removed in the six remaining rats, which were killed 12 weeks later. Six additional rats with intact teeth served as control. All incisors were fixed, demineralized, embedded in glycol methacrylate and cross-sectioned perpendicular to the long axis of the tooth. The distance of each section (2 microm) from the apex was calculated. A computerized image-analysis program was used to measure the width and area of the labial and lingual periodontal ligament to establish whether the measured segments corresponded to the compressed or expanded zones. In each cross-section, the various types of blood vessels were counted and the cross-sectional area of all venous vessels was measured. The results showed that after 2 weeks of loading (1) the general trend of vascular changes was similar under pressure and tension; (2) the large-diameter vessels were unaffected by loading; (3) the mean number of terminal arterioles had decreased significantly, while the number of capillaries and postcapillary venules had increased significantly in the apical tooth part; (4) the venous blood vessel area had decreased significantly in the apical tooth part; (5) the intensity of the vascular reaction was dependent on the degree of tissue distortion; and (6) after 12 weeks' recovery the vascular changes were still present, demonstrating a rebound effect. The findings suggest that microvascular alterations following tooth loading are not directly related to the spatial effect of loading itself and are of a much longer duration than expected.

Vascular changes in the periodontal ligament after removal of orthodontic forces

Vascular changes in the periodontal ligament after release of orthodontic force and their possible contribution to relapse of relocated teeth are poorly understood. This study documented the periodontal vascular changes after 2 weeks of tooth movement and during a 3-week period after release of orthodontic force. This study is the first comprehensive quantitative description of these events. Changes in blood vessel number and density were correlated with the direction of tooth movement (initially mesial in response to force but later distal because of relapse). Application and removal of orthodontic force produced significant changes in blood vessel number and density, which were not related to changes in tissue volume. The vascular changes were dependent on the site of evaluation and the size of the blood vessel. The periodontal vascular distribution and density can be summarized as follows: (1) increased after application of orthodontic force, (2) transient decrease subsequent to removal of force, (3) transient increase during reactivated distal drift, and (4) normalization. Normalization was achieved during an interval equivalent to the duration of orthodontic force, suggesting that the vasculature could modulate interstitial tissue pressures, resulting in relapse of relocated teeth. The role of the periodontal vasculature in alveolar remodeling and in modifying interstitial tissue fluid pressures coincident to human tooth movement requires further study.

Effect of experimental traumatic occlusion on periodontal and pulpal blood flow

Fluorescent microspheres (FM) were used to visualize and semi-quantify flood flow in the periodontal ligament (PDL) and dental pulp during experimental traumatic occlusion of the maxillary and mandibular molar teeth in young rats. At different observation points FM were injected systemically, and the number of FM was counted in serial sections from the jaws in the PDL and pulp of the molar teeth in a fluorescent microscope. Blood flow was related to the number of FM in the tissues and in a reference blood sample. In the early stages an increase in blood flow in the PDL and dental pulp was found on the experimental side compared with the contralateral side. Furthermore, there was an increase in blood flow on both sides of the jaws compared with an unoperated control material. The study thus indicates that a local unilateral occlusal trauma initiates blood flow responses in the total molar dentition in rats.

Variation of approximal tooth contact tightness with postural change

In order to investigate the role played by posture in determining posterior dental contact tightness, we measured contact tightness of maxillary and mandibular posterior teeth in ten adult subjects, while each was initially seated upright, after each had assumed a supine posture for two h, and finally after each had returned to an upright posture for two h. The technique used for measurement of contact tightness was based on frictional force concepts and consisted of the recording of the force required to withdraw a 0.038-mm-thick stainless-steel strip that had been slipped into each contact. A decreased mean tightness of all maxillary and mandibular contacts followed the change from an upright to a supine posture. The most significant decrease (-32%) occurred at the mandibular first molar-second premolar contact, and the smallest decrease (-10%) occurred at the mandibular first premolar-canine contact. An increased mean tightness of all maxillary and mandibular contacts followed a return to an upright posture. The most significant increase (20%) occurred at the maxillary first molar-second premolar contact, and the smallest increase (8%) occurred at the maxillary first premolar-canine contact. We conclude that posterior dental contact tightness, generally regarded by dentists as a static feature of occlusion, varies significantly as a function of posture.

Fenestrated capillaries in the periodontal ligaments of the erupting and erupted rat molar

Quantitative ultrastructural studies were conducted on eight rats (four aged 21 days and four aged 8 weeks) using the periodontal tissues around the mesial root of the mandibular first molar. The periodontal ligament of the erupting tooth contained significantly more capillary fenestrations than the erupted tooth, both in terms of the number per unit area of endothelium (2.2/microns2) and in terms of total number per cubic millimetre of tissue (30.5 X 10(6)/mm3). Differences were also discerned with respect to the percentage of capillaries in the tissue. Thus, the periodontal vasculature demonstrates marked morphological changes which may be related to the eruptive phase of the tooth.

Fenestrated capillaries in the connective tissues of the periodontal ligament

A quantitative ultrastructural study was undertaken to assess the number and distribution of fenestrated capillaries in the periodontal ligaments of the rat dentition. Experiments were conducted on four animals using the right mandibular incisors and first molars. For the incisor, analysis was performed in three sites along the length of the periodontal ligament. Regardless of site, there was 0.1 fenestration per micron2 of endothelium. In the basal region, the incisor periodontal ligament contained 3.5 X 10(6) fenestrations per mm3 of tissue whereas more occlusally it contained 1 X 10(6) fenestrations per mm3 of tissue. For the molar, the capillaries showed more fenestrations, 0.4 fenestration per micron2 of endothelium. There were also more per unit volume of tissue, 12 X 10(6) fenestrations per mm3. Thus, the vasculatures of the rat incisor and molar periodontal ligaments exhibit significant numbers of fenestrations which, in the case of the incisor, are not distributed uniformly along its length.

The influence of sympathetic nerve activity on axial position of the rabbit incisor tooth

Changes in position of the upper front tooth in response to sectioning and subsequent electrical stimulation of the cervical sympathetic nerves were studied in 25 anesthetized rabbits. The position was continuously recorded by an ultrasonic transit time technique. Sectioning of the nerves was found to induce an average tooth extrusion of about 7 microns. Sympathetic nerve stimulation for periods of 20-30 s caused intrusion of the tooth, with about 70% of maximum occurring at 2 Hz stimulations. The intrusive response was reduced by phentolamine. Neither atropine nor propranolol affected the stimulation response, but the latter drug led to marked extrusion of the tooth. In conclusion, the position of the rabbit's front tooth was found to be highly sensitive to alterations in sympathetic nerve activity to the vasculature of the tooth-supporting tissues.