Regular nicotine intake increased tooth movement velocity, osteoclastogenesis and orthodontically induced dental root resorptions in a rat model

Sinomenine Inhibits Orthodontic Tooth Movement and Root Resorption in Rats and Enhances Osteogenic Differentiation of PDLSCs

Purpose

To investigate the effects of sinomenine on orthodontic tooth movement and root resorption in rats, as well as the effect of sinomenine on the osteogenesis of periodontal ligament stem cells (PDLSCs).

Methods

Fifty-four male Wistar rats were randomly divided into 3 groups: control group, 20 mg/kg sinomenine group and 40 mg/kg sinomenine group. Fifty-gram orthodontic force was applied to all groups. Each group was injected intraperitoneally with corresponding concentration of sinomenine every day. After 14 days, all rats were sacrificed. Micro-computed tomography (micro-CT) scan was used to analyze tooth movement, root resorption and alveolar bone changes. The effect on periodontal tissue was analyzed by Masson, tartrate-resistant acid phosphatase (TRAP) and immunohistochemical staining. In vitro, PDLSCs were extracted and identified. The effect of sinomenine on proliferation was determined by cell-counting kit-8. The effect of sinomenine on osteogenesis was investigated by alkaline phosphatase (ALP) activity and alizarin red staining. qPCR and Western blotting were performed to explore the effects of sinomenine on the expression levels of ALP, runt-related transcription factor 2 (RUNX2), receptor activator of nuclear factor kappaB ligand (RANKL) and osteoprotegerin (OPG).

Results

The tooth movement and root resorption of sinomenine groups were reduced. Sinomenine decreased trabecular spacing on compression side and increased alveolar bone volume and trabecular thickness on tension side. TRAP-positive cells in sinomenine groups decreased significantly. The expressions of TNF-α and RANKL were decreased, while the expressions of OPG, RUNX2 and osteocalcin were up-regulated. In vitro, 0.1 M and 0.5 M sinomenine enhanced ALP activity, mineral deposition and the expression of ALP, RUNX2 and OPG, and reduced the expression of RANKL.

Conclusion

Sinomenine could inhibit tooth movement, reduce root resorption, and exert a positive effect on bone formation in rats. Moreover, sinomenine promoted the osteogenesis of PDLSCs.

Dietary salt and myeloid NFAT5 (nuclear factor of activated T cells 5) impact on the number of bone-remodelling cells and frequency of root resorption during orthodontic tooth movement

PURPOSE

The aim of the study was to investigate the impact of dietary salt and the osmoprotective transcription factor nuclear factor of activated T cells 5 (NFAT5) in myeloid cells on bone remodelling cells as osteocytes, osteoblasts and osteoclasts and on force-induced dental root resorptions in a mouse model.

METHODS

Control mice and mice lacking myeloid NFAT5 (nuclear factor of activated T cells 5) were either kept on low, normal or high salt diets. After one week on the specified diet an elastic band was inserted between the first and second molar to induce orthodontic tooth movement. One week later the mice were euthanised and jaws were fixed for histological analysis. Osteocyte, osteoblast and osteoclast numbers as well as extent of root resorptions were assessed histologically.

RESULTS

Osteocyte number was diminished with high salt diet in wildtype mice. Osteoblast numbers increased with low salt diet in control mice and reduced with high salt diet in mice without NFAT5 in myeloid cells. High salt diet tended to increase osteoclast number in control mice. In mice without myeloid NFAT5, numbers of osteoclasts were reduced under high salt diet. Frequency of force-induced root resorptions tended to be dependent on dietary salt content in control mice.

CONCLUSION

During orthodontic tooth movement dietary salt impacts on the frequency of root resorptions and the number of osteoclasts and osteoblasts in alveolar bone of mice. This can affect bone remodelling during orthodontic treatment. Myeloid NFAT5 impacts on this salt-dependent reaction.

Identifying periodontitis risk factors through a retrospective analysis of 80 cases

Objectives:

To investigate periodontitis risk factors and to establish a reference framework for identifying factors that place individuals at greater risk for periodontitis.

Methods:

Clinical data from 80 periodontitis patients admitted in the Department of Stomatology at Hebei Provincial People’s Hospital and treated between March 2020 and March 2021 were retrospectively analyzed.

Results:

Univariate analysis showed that lower daily brushing frequencies, decreased tooth brushing duration, decreased scaling frequency, dietary habits, smoking and drinking, genetic factors, diabetes, hypertension, and obesity were more prevalent among periodontitis patients than healthy controls. Multivariate binary logistic analysis showed that daily brushing frequency, routine scaling, smoking, drinking, heredity, diabetes, hypertension, and obesity were all risk factors for periodontitis.

Conclusions:

There are many risk factors for periodontitis. Clinicians need to be aware of these factors for early detection and treatment of the disease.

Cigarette Smoke Exposure Inhibits Osteoclast Apoptosis via the mtROS Pathway

It is widely known that smoking is a risk factor for bone loss and plays a key role in osteopenia. Despite this well-known association, the mechanisms by which smoking affects bone have not been definitively established. Since smoking increases bone loss and potentially affects bone resorption in response to mechanical force, we investigated the impact of cigarette smoke on osteoclast numbers and underlying mechanisms in a mouse model of orthodontic tooth movement (OTM). The experimental group was exposed to once-daily cigarette smoke while the control group was not, and tooth movement distance and osteoclast numbers were assessed. In addition, the effect of cigarette smoke extract (CSE) on osteoclast precursor proliferation and osteoclast apoptosis was assessed in vitro. We found that cigarette smoke exposure enhanced bone remodeling stimulated by mechanical force and increased osteoclast numbers in vivo. Also, CSE increased the number of osteoclasts by inhibiting osteoclast apoptosis via the mitochondrial reactive oxygen species/cytochrome C/caspase 3 pathway in vitro. Moreover, exposure of mice to cigarette smoke affected bone marrow cells, leading to increased formation of osteoclasts in vitro. This study identifies a previously unknown mechanism of how smoking has a detrimental impact on bone.

Establishing a new alveolar cleft model in rats to investigate the influence of jaw reconstructions on orthodontic tooth movement

BACKGROUND

The aim of the present investigation was to develop a new cleft model in rats that allows alveolar cleft repair and subsequent tooth movement.

METHODS

A complete continuity-interrupting alveolar cleft was performed on the left-side maxillae of 33 rats through ultrasonic surgery. The clefts were filled with bone wax, and microCT scans were done to analyze the cleft size. After four weeks, the cleft repair was completed using autologous, xenogeneic (human), or synthetic bone substitute. After an additional four weeks, the orthodontic tooth movement was initiated.

RESULTS

Fourteen rats died during the research, and the study design was constantly adapted accordingly. The main reasons for death included breathing problems during or immediately after the experimental activities (eight animals), followed by two deaths due to circulatory failures. In the remaining 19 animals, the average cleft size was about 2.70 ± 0.46 × 2.01 ± 0.25 × 1.18 ± 0.20 mm, and the mean velocity of orthodontic tooth movement after seven days was between 0.21 ± 0.08 mm in the autologous group and 0.50 ± 0.54 mm in the xenogeneic group. After 56 days, the mean values ranged between 0.67 ± 0.27 mm in the autologous group and 0.82 ± 0.72 mm in the synthetic group.

CONCLUSIONS

Surgical interventions in the oral cavity of rats requires a stronger anesthesia and lead to increased risk of coolant and coagulated blood aspiration. The new alveolar cleft model in rats allows for subsequent orthodontic tooth movement after cleft repair, but only in the mesial root of the first molar.

Effect of nicotine exposure on the rate of orthodontic tooth movement: A meta-analysis based on animal studies

Background

Nicotine exposure has been reported to modify bone cell function and the osseous metabolism with potential effects on the rate of orthodontic tooth movement.

Objectives

To systematically investigate and quantitively synthesize the most recent available evidence from animal studies regarding the effect of nicotine exposure on the rate of orthodontic tooth movement.

Search methods

Unrestricted searches in 7 databases and hand searching were performed until July 2020 (PubMed, Central, Cochrane Database of Systematic Reviews, SCOPUS, Web of Science, Arab World Research Source, ProQuest Dissertations and Theses Global).

Selection criteria

We searched for controlled studies on healthy animals investigating the effect of nicotine on the rate of orthodontic tooth movement.

Data collection and analysis

Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed using the SYRCLE’s Risk of Bias Tool. Exploratory synthesis and meta-regression were carried out using the random effects model.

Results

From the initially identified records, 5 articles meeting the inclusion criteria were selected and no specific concerns regarding bias were identified. Quantitative data synthesis showed that the rate of orthodontic tooth movement in the nicotine exposed rats was higher than in the control group animals (2 weeks of force application; 0.317 mm more movement in nicotine exposed rats; 95% Confidence Interval: 0.179–0.454; p = 0.000). No effect of the concentration or the duration force application was demonstrated following exploratory meta-regression.

Conclusion

Rats administered with nicotine showed accelerated rates of orthodontic tooth movement. Although, information from animal studies cannot be fully translated to human clinical scenarios, safe practice would suggest that the orthodontist should be able to identify patients exposed to nicotine and consider the possible implications for everyday clinical practice.

Gene expression and phosphorylation of ERK and AKT are regulated depending on mechanical force and cell confluence in murine cementoblasts

Cementoblasts, located on the tooth root surface covered with cementum, are considered to have tooth protecting abilities. They prevent tissue damage and secure teeth anchorage inside the periodontal ligament during mechanical stress. However, the involvement of cementoblasts in mechanical compression induced periodontal remodeling needs to be identified and better understood. Here, we investigated the effect of static compressive stimulation, simulating the compression side of orthodontic force and cell confluence on a murine cementoblast cell line (OC/CM). The influence of cell confluence in cementoblast cells was analyzed by MTS assay and immunostaining. Furthermore, mRNA and protein expression were investigated by real-time RT-PCR and western blotting at different confluence grades and after mechanical stimulation. We observed that cementoblast cell proliferation increases with increasing confluence grades, while cell viability decreases in parallel. Gene expression of remodeling markers is regulated by compressive force. In addition, cementoblast confluence plays a crucial role in this regulation. Confluent cementoblasts show a significantly higher basal expression of Bsp, Osterix, Alpl, Vegfa, Mmp9, Tlr2 and Tlr4 compared to sub-confluent cells. After compressive force of 48 h at 60% confluence, an upregulation of Bsp, Osterix, Alpl, Vegf and Mmp9 is observed. In contrast, at high confluence, all analyzed genes were downregulated through mechanical stress. We also proved a regulation of ERK, phospho-ERK and phospho-AKT dependent on compressive force. In summary, our findings provide evidence that cementoblast physiology and metabolism is highly regulated in a cell confluence-dependent manner and by mechanical stimulation.

Effects of Histamine Receptor Antagonist Cetirizine on Orthodontic Tooth Movement

Many patients regularly take histamine receptor antagonists, such as cetirizine, to prevent allergic reactions, but these antiallergic drugs may have inadvertent effects on orthodontic treatment. In previous studies, histamine has been shown to modulate the sterile inflammatory reaction underlying orthodontic tooth movement. Pertinent effects of histamine antagonization via cetirizine during orthodontic treatment, however, have not been adequately investigated. We thus treated male Fischer344 rats either with tap water (control group) or cetirizine by daily oral gavage corresponding to the clinically used human dosage adjusted to the rat metabolism (0.87 mg/kg) or to a previously published high dosage of cetirizine (3 mg/kg). Experimental anterior movement of the first upper left molar was induced by insertion of a nickel-titanium (NiTi) coil spring (0.25 N) between the molar and the upper incisors. Cone-beam computed tomography (CBCT), micro-computed tomography (µCT) images, as well as histological hematoxylin-eosin (HE), and tartrate-resistant acid phosphatase (TRAP) stainings were used to assess the extent of tooth movement, cranial growth, periodontal bone loss, root resorptions, and osteoclast activity in the periodontal ligament. Both investigated cetirizine dosages had no impact on the weight gain of the animals and, thus, animal welfare. Neither the extent of tooth movement, nor cranial growth, nor root resorption, nor periodontal bone loss were significantly influenced by the cetirizine dosages investigated. We, thus, conclude that histamine receptor antagonist cetirizine can be used during orthodontic treatment to prevent allergic reactions without clinically relevant side effects on orthodontic tooth movement.

Compressive force strengthened the pro-inflammatory effect of zoledronic acid on il-1ß stimulated human periodontal fibroblasts

OBJECTIVES

The number of patients in dentistry taking bisphosphonates (BP) increases every year. There are only little data about the influence of biomechanical stress due to orthodontic treatment and periodontal inflammation in BP patients. This study focused on the effects of the induced inflammation by IL-1ß in compressed human periodontal ligament fibroblasts (HPdLF) exposed to the nitrogen-containing BP zoledronate in vitro.

MATERIALS AND METHODS

HPdLF were incubated with 5 μmol/l zoledronate and 10 ng/ml IL-1ß for 48 h. In the last 3 h, cells were exposed to a compressive, centrifugal force of 34.9 g/cm². Cell viability was analyzed directly after the compressive force by MTT assay. Gene expression of COX-2 and IL-6 was investigated using quantitative qRT-PCR. PGE-2 and IL-6 protein secretion were measured via ELISA.

RESULTS

The cell viability of HPdLF was not affected. Without inflammatory pre-stimulation, COX-2 expression was increased by compression and zoledronate. IL-6 expression was increased under compression. On secretion level, the combination of compression and zoledronate induced a slightly increase of IL-6 secretion. In contrast, inflammatory pre-stimulation strengthened the compressive upregulation of COX-2, as well as induced a higher PGE-2 secretion. Further addition of zoledronate to pre-stimulated cells additionally strengthened the compression-induced upregulation of COX-2 and IL-6 expression as well as protein secretion compared to all other groups.

CONCLUSIONS

Biomechanical stress might trigger a pro-inflammatory potential of BP further enhanced in the presence of an inflammatory pre-stimulation.

CLINICAL RELEVANCE

To prevent excessive host inflammatory responses, occlusal overloading and mechanical stress due to orthodontic treatment should be avoided in BP patients with untreated periodontitis.

Qualitative and quantitative assessment of the potential effect of cigarette smoking on enamel of human smokers' teeth

OBJECTIVE

This study aimed to examine the potential changes in enamel surface of human smokers' teeth.

MATERIALS AND METHODS

Forty extracted permanent, human, noncarious anterior teeth were used in this study. Half of these teeth were obtained from heavy smokers, while the other half of teeth were collected from nonsmokers (control teeth). The teeth were then subjected for scanning electron microscopic examination together with energy dispersive X ray and micro-hardness analysis to evaluate the qualitative and quantitative effect of smoking respectively.

RESULTS

SEM of smokers' teeth showed variable degrees of destruction from small areas of demineralization as holes and pits to destruction and deterioration of the organizational pattern of the rod substance. Moreover, areas of defective remineralization were detected. The microhardness, calcium and phosphorus weight % significantly decreased whereas the Ca/P ratio was significantly increased.

CONCLUSION

Cigarette smoking adversely affected the ultrastructure and mechanical properties of enamel and even hindered the normal remineralization process thus cigarette smoking cessation should be promoted in the dental office daily practices.

The role of HIF-1α in nicotine-induced root and bone resorption during orthodontic tooth movement

BACKGROUND

In orthodontic tooth movement (OTM), pseudo-inflammatory processes occur that are similar to those of nicotine-induced periodontitis. Previous studies have shown that nicotine accelerates OTM, but induces periodontal bone loss and dental root resorption via synergistically increased osteoclastogenesis. This study aimed to investigate the role of hypoxia-inducible factor 1 alpha (HIF-1α) in nicotine-induced osteoclastogenesis during OTM.

MATERIALS/METHODS

Male Fischer-344 rats were treated with l-Nicotine (1.89 mg/kg/day s.c., N = 10) or NaCl solution (N = 10). After a week of premedication, a NiTi spring was inserted to mesialize the first upper left molar. The extent of dental root resorption, osteoclastogenesis, and HIF-1α protein expression was determined by (immuno)histology, as well as bone volume (BV/TV) and trabecular thickness (TbTh) using µCT. Receptor activator of nuclear factor of activated B-cells ligand (RANK-L), osteoprotegerin (OPG), and HIF-1α expression were examined at the protein level in periodontal ligament fibroblasts (PDLF) exposed to pressure, nicotine and/or hypoxia, as well as PDLF-induced osteoclastogenesis in co-culture experiments with osteoclast progenitor cells.

RESULTS

Nicotine favoured dental root resorptions and osteoclastogenesis during OTM, while BV/TV and TbTh were only influenced by force. This nicotine-induced increase does not appear to be mediated by HIF-1α, since HIF-1α was stabilized by force application and hypoxia, but not by nicotine. The in vitro data showed that the hypoxia-induced increase in RANK-L/OPG expression ratio and PDLF-mediated osteoclastogenesis was less pronounced than the nicotine-induced increase.

CONCLUSIONS

Study results indicate that the nicotine-induced increase in osteoclastogenesis and periodontal bone resorption during OTM may not be mediated by hypoxic effects or HIF-1α stabilization in the context of nicotine-induced vasoconstriction, but rather by an alternative mechanism.

Comparative assessment of mouse models for experimental orthodontic tooth movement

Animal experiments are essential for the elucidation of biological-cellular mechanisms in the context of orthodontic tooth movement (OTM). So far, however, no studies comparatively assess available mouse models regarding their suitability. OTM of first upper molars was induced in C57BL/6 mice either via an elastic band or a NiTi coil spring for three, seven or 12 days. We assessed appliance survival rate, OTM and periodontal bone loss (µCT), root resorptions, osteoclastogenesis (TRAP⁺ area) and local expression of OTM-related genes (RT-qPCR). Seven days after the elastic bands were inserted, 87% were still in situ, but only 27% after 12 days. Survival rate for the NiTi coil springs was 100% throughout, but 8.9% of the animals did not survive. Both methods induced significant OTM, which was highest after 12 (NiTi spring) and 7 days (band), with a corresponding increase in local gene expression of OTM-related genes and osteoclastogenesis. Periodontal bone loss and root resorptions were not induced at a relevant extent by neither of the two procedures within the experimental periods. To induce reliable OTM in mice beyond 7 days, a NiTi coil spring is the method of choice. The elastic band method is recommended only for short-term yes/no-questions regarding OTM.

Effects of sodium chloride on the gene expression profile of periodontal ligament fibroblasts during tensile strain

Purpose

During orthodontic tooth movement, pressure and tension zones develop in the periodontal ligament, and periodontal ligament fibroblasts (PDLF) become exposed to mechanical strain. Enhanced salt (NaCl) concentrations are known to modulate responses of PDLF and immune cells to different stimuli like mechanical strain. Here, we investigated the impact of tensile strain on the gene expression profile of PDLF under normal (NS) and high salt (HS) conditions.

Methods

After preincubation under NS or HS (+40 mM NaCl in medium) conditions for 24 h, PDLF were stretched 16% for 48 h using custom-made spherical cap silicone stamps using an established and published setup. After determination of cell number and cytotoxicity, we analyzed expression of genes involved in extracellular matrix reorganization, angiogenesis, bone remodeling, and inflammation by quantitative real-time polymerase chain reaction (RT-qPCR).

Results

Tensile strain did not affect the expression of genes involved in angiogenesis or extracellular matrix reorganization by PDLF, which however modulate inflammatory responses and bone remodeling in reaction to 16% static tensile strain. Salt (NaCl) treatment triggered enhanced extracellular matrix formation, expression of cyclooxygenase 2 and bone metabolism in PDLF during tensile strain.

Conclusions

Salt (NaCl) consumption may influence orthodontic tooth movement and periodontal bone loss via modulation of extracellular matrix and bone metabolism. Excessive salt intake during orthodontic therapy may cause adverse effects regarding periodontal inflammation and bone resorption.

Harmful chemicals emitted from electronic cigarettes and potential deleterious effects in the oral cavity

Use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigs), is increasing across the US population and is particularly troubling due to their adoption by adolescents, teens, and young adults. The industry’s marketing approach for these instruments of addiction has been to promote them as a safer alternative to tobacco, a behavioral choice supporting smoking cessation, and as the ‘cool’ appearance of vaping with flavored products (e.g. tutti frutti, bubble gum, and buttered popcorn etc.). Thus, there is a clear need to better document the health outcomes of e-cig use in the oral cavity of the addicted chronic user. There appears to be an array of environmental toxins in the vapors, including reactive aldehydes and carbonyls resulting from the heating elements action on fluid components, as well as from the composition of chemical flavoring agents. The chemistry of these systems shows that the released vapors from the e-cigs frequently contain levels of environmental toxins that considerably exceed federal occupational exposure limits. Additionally, the toxicants in the vapors appear to be retained in the host fluids/tissues at levels often approximating 90% of the levels in the e-cig vapors. These water-soluble reactive toxins can challenge the oral cavity constituents, potentially contributing to alterations in the autochthonous microbiome and host cells critical for maintaining oral homeostasis. This review updates the existing chemistry/environmental aspects of e-cigs, as well as providing an overview of the somewhat limited data on potential oral health effects that could occur across the lifetime of daily e-cig users.

Housekeeping gene validation for RT-qPCR studies on synovial fibroblasts derived from healthy and osteoarthritic patients with focus on mechanical loading

Selection of appropriate housekeeping genes is essential for the validity of data normalization in reverse transcription quantitative PCR (RT-qPCR). Synovial fibroblasts (SF) play a mediating role in the development and progression of osteoarthritis (OA) pathogenesis, but there is no information on reliable housekeeping genes available. Therefore the goal of this study was to identify a set of reliable housekeeping genes suitable for studies of mechanical loading on SF from healthy and OA patients. Nine genes were evaluated towards expression stability and ranked according their relative stability determined by four different mathematical procedures (geNorm, NormFinder, BestKeeper and comparative ΔC_q). We observed that RPLP0 (ribosomal protein, large, P0) and EEF1A1 (eukaryotic translation elongation factor 1 alpha 1) turned out to be the genes with the most stable expression in SF from non-OA or OA patients treated with or without mechanical loading. According to geNorm two genes are sufficient for normalization throughout. Expression of one tested target gene varied considerably, if normalized to different candidate housekeeping genes. Our study provides a tool for accurate and valid housekeeping gene selection in gene expression experiments on SF from healthy and OA patients with and without mechanical loading in consistent with the MIQE (Minimum Information for Publication of Quantitative Real-Time PCR Experiments) guidelines and additionally demonstrates the impact of proper housekeeping gene selection on the expression of the gene of interest.

Orthodontic cell stress modifies proinflammatory cytokine expression in human PDL cells and induces immunomodulatory effects via TLR-4 signaling in vitro

OBJECTIVE

Biomechanical orthodontics loading of the periodontium initiates a cascade of inflammatory signaling events that induce periodontal remodeling and finally facilitate orthodontic tooth movement. Pattern recognition receptors such as toll-like receptors (TLRs) have been well characterized for their ability to induce the activation of inflammatory, immunomodulatory cytokines. Here, we examined whether the cellular response of human periodontal ligament (hPDL) cells to mechanical stress involves TLR-4 signaling in vitro.

MATERIALS AND METHODS

Confluent hPDL cells were cultured in the presence of 5 μg/ml TLR-4 antibody (TLR-4ab) for 1 h prior to the induction of compressive forces by the use of round glass plates for 24 h. At harvest, interleukin-6 and interleukin-8 (IL-6, IL-8) mRNA and protein expression were analyzed by real-time PCR and ELISA. The immunomodulatory role of mechanical cell stress and TLR-4 signaling was addressed in co-culture experiments of hPDL and THP-1 cells targeting monocyte adhesion and by culturing osteoclastic precursors (RAW 264.7) in the presence of the conditioned medium of hPDL cells that had been mechanically loaded before.

RESULTS

Basal expression of IL-6 and IL-8 was not affected by TLR-4ab, but increased significantly upon mechanical loading of hPDL cells. When cells were mechanically stressed in the presence of TLR-4ab, the effect seen for loading alone was markedly reduced. Likewise, monocyte adhesion and osteoclastic differentiation were enhanced significantly by mechanical stress of hPDL cells and this effect was partially inhibited by TLR-4ab.

CONCLUSIONS

The results of the present study indicate a proinflammatory and immunomodulatory influence of mechanical loading on hPDL cells. Intracellular signaling involves a TLR-4-dependent pathway.

CLINICAL RELEVANCE

These findings hold out the prospect of interfering with the cellular response to mechanical cell stress in order to minimize undesired side effects of orthodontic tooth movement.

Systematic review of biological therapy to accelerate orthodontic tooth movement in animals: Translational approach

OBJECTIVES

To systematically review and evaluate what is known regarding contemporary biological therapy capable of accelerating orthodontic tooth movement (OTM) in animal model.

MATERIALS AND METHODS

MedLine, Scopus, Web of Science and OpenGrey were searched without restrictions until June 2019. Following study retrieval and selection, relevant data was extracted using a standardized table. Risk of bias (RoB) assessment was performed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool.

RESULTS

Fifty-one animal studies were included. Two biological therapies were identified as capable of accelerating the OTM: chemical methods (49 studies) and gene therapy (2 studies). The main substances that increased the OTM rate were cytokines (13 studies), followed by growth factors (6 studies) and hormones (5 studies). Most studies were assessed to be at unclear or high RoB. The application protocols, measurement and reporting of outcomes varied widely and methodologies were not adequately reported.

CONCLUSIONS

Although biological therapies to accelerate OTM have been widely tested and effective in preclinical studies, the validity of the evidence is flawed to support translational of these results. There is a need for well-designed experimental studies to translate these methods for clinical field.

The role of mechanotransduction versus hypoxia during simulated orthodontic compressive strain-an in vitro study of human periodontal ligament fibroblasts

During orthodontic tooth movement (OTM) mechanical forces trigger pseudo-inflammatory, osteoclastogenic and remodelling processes in the periodontal ligament (PDL) that are mediated by PDL fibroblasts via the expression of various signalling molecules. Thus far, it is unknown whether these processes are mainly induced by mechanical cellular deformation (mechanotransduction) or by concomitant hypoxic conditions via the compression of periodontal blood vessels. Human primary PDL fibroblasts were randomly seeded in conventional six-well cell culture plates with O₂-impermeable polystyrene membranes and in special plates with gas-permeable membranes (Lumox®, Sarstedt), enabling the experimental separation of mechanotransducive and hypoxic effects that occur concomitantly during OTM. To simulate physiological orthodontic compressive forces, PDL fibroblasts were stimulated mechanically at 2 g·cm⁻² for 48 h after 24 h of pre-incubation. We quantified the cell viability by MTT assay, gene expression by quantitative real-time polymerase chain reaction (RT-qPCR) and protein expression by western blot/enzyme-linked immunosorbent assays (ELISA). In addition, PDL-fibroblast-mediated osteoclastogenesis (TRAP⁺ cells) was measured in a 72-h coculture with RAW264.7 cells. The expression of HIF-1α, COX-2, PGE2, VEGF, COL1A2, collagen and ALPL, and the RANKL/OPG ratios at the mRNA/protein levels during PDL-fibroblast-mediated osteoclastogenesis were significantly elevated by mechanical loading irrespective of the oxygen supply, whereas hypoxic conditions had no significant additional effects. The cellular–molecular mediation of OTM by PDL fibroblasts via the expression of various signalling molecules is expected to be predominantly controlled by the application of force (mechanotransduction), whereas hypoxic effects seem to play only a minor role. In the context of OTM, the hypoxic marker HIF-1α does not appear to be primarily stabilized by a reduced O₂ supply but is rather stabilised mechanically.

Three-dimensional analysis of the physiologic drift of adjacent teeth following maxillary first premolar extractions

We assessed the three-dimensional (3D) pattern of the physiologic drift of the remaining adjacent teeth after premolar extraction due to orthodontic reasons and the associated factors. Data were collected from 45 patients aged 17.04 ± 5.14 years who were scheduled to receive a fixed appliance after maxillary premolar extraction. Seventy-five drift models were obtained and digitalized via 3D scanning. The average physiologic drift duration was 81.66 ± 70.03 days. Angular and linear changes in the first molars, second premolars, and canines were measured using the 3D method. All the examined teeth had tipped and moved towards the extraction space, leading to space decreases. Posterior teeth primarily exhibited significant mesial tipping and displacement, without rotation or vertical changes. All canine variables changed, including distal inward rotation and extrusion. The physiologic drift tended to slow over time. Age had a limited negative effect on the mesial drift of posterior teeth, whereas crowding had a limited positive effect on canine drift. Thus, the mesial drift of molars after premolar extraction may lead to molar anchorage loss, particularly among younger patients. The pattern of the physiologic drift of maxillary canines can help relieve crowding and facilitate labially ectopic canine alignment, whereas canine drift is accelerated by more severe crowding.

Sodium-chloride-induced effects on the expression profile of human periodontal ligament fibroblasts with focus on simulated orthodontic tooth movement

Increased salt (NaCl) consumption triggers chronic diseases such as hypertension or osteopenia. Its impact on orthodontic tooth movement and periodontitis, however, has not been investigated, although both processes are related to the immune system, with periodontal ligament fibroblasts (PDLFs) playing a key mediating role. Here, we investigated the impact of NaCl on the expression pattern of PDLFs in a model of simulated compressive orthodontic strain. Periodontal ligament fibroblasts were preincubated for 24 h with additional 0 or 40 mM NaCl and concurrently treated for another 48 h with or without compressive strain of 2 g cm^-2 . We analyzed the expression of genes and proteins involved in orthodontic tooth movement by reverse transcription quantitative polymerase chain reaction (RT-qPCR), ELISA, and immunoblot. Co-culture experiments were performed to observe PDLF-mediated osteoclastogenesis. A higher (40 mM) concentration of NaCl in the culture medium resulted in increased secretion of prostaglandin, expression of alkaline phosphatase, and expression of genes involved in extracellular matrix remodeling, but decreased compression-induced expression of the interleukin-6 (IL6) gene. The 40 mM concentration of NaCl also enhanced receptor activator of nuclear factor kappa-B ligand (RANKL) but reduced that of osteoprotegerin (OPG), resulting in upregulated PDLF-mediated osteoclastogenesis. A high NaCl concentration in the periodontal ligament, corresponding to a high-salt diet in vivo, may influence orthodontic tooth movement and periodontitis through increased secretion of prostaglandins by PDLFs and upregulated PDLF-mediated osteoclastogenesis, possibly accelerating orthodontic tooth movement and propagating periodontitis and periodontal bone loss.

Effects of ethanol on human periodontal ligament fibroblasts subjected to static compressive force

Consumption of toxic substances such as alcohol is widespread in the general population and thus also in patients receiving orthodontic treatment. Since human periodontal ligament (hPDL) fibroblasts play a key role in orthodontic tooth movement (OTM) by expressing cytokines and chemokines, we wanted to clarify whether ethanol modulates the physiological activity and expression pattern of hPDL fibroblasts during static compressive force application. We pre-incubated hPDL fibroblasts for 24 h with different ethanol concentrations, corresponding to casual (0.041% blood alcohol concentration [BAC], % by volume) and excessive (0.179%) alcohol consumption. At each ethanol concentration, we incubated the cells for another 48 h with and without an additional physiological compressive force of 2 g/cm² occurring during orthodontic tooth movement in compression areas of the periodontal ligament. Thereafter, we analyzed expression and secretion of genes and proteins involved in OTM regulation by RT-qPCR and ELISA. We also performed co-culture experiments to observe hPDL-fibroblast-mediated osteoclastogenesis. We observed no effects of ethanol on cytotoxicity or cell viability of hPDL fibroblasts in the applied concentrations. Ethanol showed an enhancing effect on angiogenesis and activity of alkaline phosphatase. Simultaneously, ethanol reduced the induction of IL-6 and increased prostaglandin E₂ synthesis as well as hPDL-fibroblast-mediated osteoclastogenesis without affecting the RANK-L/OPG-system. hPDL fibroblasts thus seem to be a cell type quite resistant to ethanol, as no cytotoxic effects or influence on cell viability were detected. High ethanol concentrations, however, seem to promote bone formation and angiogenesis. Ethanol at 0.179% also enhanced hPDL-induced osteoclastogenesis, indicating increased bone resorption and thus tooth movement velocity to be expected during orthodontic therapy.

Effects of the Highly COX-2-Selective Analgesic NSAID Etoricoxib on Human Periodontal Ligament Fibroblasts during Compressive Orthodontic Mechanical Strain

Human periodontal ligament (hPDL) fibroblasts play a major role during periodontitis and orthodontic tooth movement, mediating periodontal inflammation, osteoclastogenesis, and collagen synthesis. The highly COX-2-selective NSAID etoricoxib has a favorable systemic side effect profile and high analgesic efficacy, particularly for orthodontic pain. In this in vitro study, we investigated possible side effects of two clinically relevant etoricoxib concentrations on the expression pattern of mechanically strained hPDL fibroblasts and associated osteoclastogenesis in a model of simulated orthodontic compressive strain occurring during orthodontic tooth movement. hPDL fibroblasts were incubated for 72 h under physiological conditions with etoricoxib at 0 μM, 3.29 μM, and 5.49 μM, corresponding to clinically normal and subtoxic dosages, with and without mechanical strain by compression (2 g/cm²) for the final 48 h, simulating conditions during orthodontic tooth movement in compressive areas of the periodontal ligament. We then determined gene and/or protein expression of COX-2, IL-6, PG-E₂, RANK-L, OPG, ALPL, VEGF-A, P4HA1, COL1A2, and FN1 via RT-qPCR, ELISA, and Western blot analyses as well as apoptosis, necrosis, cell viability, and cytotoxicity via FACS, MTT, and LDH assays. In addition, hPDL fibroblast-mediated osteoclastogenesis was assessed by TRAP staining in coculture with RAW267.4 cells for another 72 h. Gene and protein expression of all evaluated factors was significantly induced by the mechanical compressive strain applied. Etoricoxib at 3.29 μM and 5.49 μM significantly inhibited PG-E₂ synthesis, but not COX-2 and IL-6 gene expression nor RANK-L-/OPG-mediated osteoclastogenesis or angiogenesis (VEGF-A). Extracellular matrix remodeling (COL1A2, FN1) and bone anabolism (ALPL), by contrast, were significantly stimulated particularly at 5.49 μM. In general, no adverse etoricoxib effects on hPDL fibroblasts regarding apoptosis, necrosis, cell viability, or cytotoxicity were detected. Clinically dosed etoricoxib, that is, a highly selective COX-2 inhibition, did not have substantial effects on hPDL fibroblast-mediated periodontal inflammation, extracellular matrix remodeling, RANK-L/OPG expression, and osteoclastogenesis during simulated orthodontic compressive strain.

Obesity attenuates force-induced tooth movement in mice with the elevation of leptin level: a preliminary translational study

Increasing number of patients with high body-mass index (BMI) are encountered in the orthodontic clinic with the growing prevalence of obesity and overweight worldwide. Some clinical studies found that the rate of orthodontic tooth movement (OTM) in obese patients decreased. However, how obesity can impact OTM has not been determined yet. Here, we used the high-fat diet (HFD) induced obese mouse model to translate this clinical problem to the basic research, and back to exploring the potential clinical applications. C57BL/6J mice were fed with high-fat diet (HFD) for 5 weeks to induce obesity and orthodontic nickel-titanium springs were applied to the upper first molars to establish OTM model. The serum level of leptin was tested by ELISA. Mouse macrophage cell line RAW264.7 cells were used as osteoclast progenitor cells stimulated by sRANKL with the presence or absence of letpin in vitro. TRAP staining was used to detect osteoclasts. Leptin was administrated intraperitoneally in mice to determine whether it can affect OTM in vivo. In obese mice, we found that OTM was attenuated and the number of osteoclasts decreased with the elevated serum level of leptin. Mechanically, we confirmed that leptin inhibited osteoclastogenesis and osteoclast functional genes expression. To translate our findings back to potential applications, we then revealed the administration of leptin could decrease OTM in wild type mice along with the decreased number of TRAP-positive osteoclasts. Taken together, these results demonstrated that the elevated level of leptin in obese mice was able to inhibit osteoclastogenesis and decrease OTM. Administration of leptin could inhibit molar mesial movement and possessed the potential to be a clinical anchorage reinforcement method.

Tobacco-induced suppression of the vascular response to dental plaque

Cigarette smoking presents oral health professionals with a clinical and research conundrum: reduced periodontal vascular responsiveness to the oral biofilm accompanied by increased susceptibility to destructive periodontal diseases. This presents a significant problem, hampering diagnosis and complicating treatment planning. The aim of this review is to summarize contemporary hypotheses that help to explain mechanistically the phenomenon of a suppressed bleeding response to dysbiotic plaque in the periodontia of smokers. The influence of smoke exposure on angiogenesis, innate cell function, the production of inflammatory mediators including cytokines and proteases, tobacco-bacteria interactions, and potential genetic predisposition are discussed.

Effects of the highly COX-2-selective analgesic NSAID etoricoxib on the rate of orthodontic tooth movement and cranial growth

BACKGROUND

NSAID analgesics have found widespread use in the treatment of pain, inflammation and fever. The highly COX-2-selective NSAID etoricoxib has shown a favorable side effect profile and excellent analgesic efficacy, particularly for dental and orthodontic pain, surpassing the current standard analgesic in orthodontics, acetaminophen. However, potential side effects on the rate of orthodontic tooth movement (OTM) and cranial growth, relevant for clinical usability during orthodontic treatment, have not yet been investigated.

MATERIAL AND METHODS

40 male Fischer344 rats were randomly assigned to 4 groups (n=10) - controls receiving only 1.5ml tap water per day by oral gavage for a total of 5 weeks (1) as well as rats receiving an additional daily normal etoricoxib dosage of 7.8mg/kg for 3d (2) and 7d/week (3) and a high dosage of 13.1mg/kg for 7d/week (4) with serum bioavailability assessed by liquid chromatography-mass spectrometry. After one week of premedication, the first upper left molars (M1) were moved orthodontically in anterior direction for 4 weeks using a closed NiTi coil spring (0.25N) and OTM as well as sagittal cranial growth were quantified cephalometrically by CBCT imaging at the start and end of OTM.

RESULTS

OTM, quantified as anterior metric tipping of M1, was significantly inhibited by about 33% only in rats receiving high-dose etoricoxib 7d/week (p=0.046) with a respective, but insignificant tendency also detectable for the normal dosages, whereas sagittal cranial growth was by tendency slightly increased with rising etoricoxib dosages, reflected by corresponding steady-state serum concentrations, confirming etoricoxib bioavailability.

CONCLUSIONS

An etoricoxib-induced clinically relevant deceleration of OTM is not to be expected at dosage regimens used in clinical practice to treat dental or orthodontic pain in contrast to a continuously administered high dosage. Due to its favorable side effect profile and higher analgesic efficiency regarding dental and orthodontic pain, etoricoxib should be a clinically valid alternative to the current standard orthodontic analgesic acetaminophen with its associated higher risk profile.

Expression kinetics of human periodontal ligament fibroblasts in the early phases of orthodontic tooth movement

PURPOSE

Human periodontal ligament (hPDL) fibroblasts play a crucial mediating role in orthodontic tooth movement (OTM). In this study, we investigated the expression kinetics of genes associated with OTM in its early phase to obtain better insight into the timing and regulation of molecular and cellular signalling and transformation processes occurring in compressive areas of the periodontal ligament during OTM.

METHODS

Adherent hPDL fibroblasts were stimulated with physiological orthodontic compressive forces of 2 g/cm² for 24, 48, 72, and 96 h under cell culture conditions. At each time point, we quantified relative gene expression of genes involved in bone remodelling (ALPL), inflammation (COX2, IL-6), extracellular matrix reorganization (COL1A2, P4HA1, FN1, MMP8) and angiogenesis (VEGF-A) by means of RT-qPCR as well as protein expression of osteoclastogenesis-regulating RANK-L and OPG relative to pressure-untreated controls incubated for corresponding time periods. In addition, coculture experiments with osteoclast precursor cells were performed to determine the extent of hPDL-fibroblast-mediated osteoclastogenesis (TRAP staining).

RESULTS

As primary response to compressive forces within 24 h, we observed an induction of genes associated with angiogenesis, inflammation, osteoblastogenesis, and the remodelling of the extracellular matrix, with RANK-L expression at first slightly inhibited and only increased after 48 h. Major hPDL-mediated osteoclastogenesis was observed after 72 h with minor, non-RANK-L-dependent osteoclastogenesis occurring as early as 24 h after compressive force application.

CONCLUSIONS

hPDL fibroblasts seem to play a major mediating role in the early phase of OTM with a differentiated, time-dependent regulation and expression pattern of cytokines and other mediators.

Influence of nicotine on orthodontic tooth movement: A systematic review of experimental studies in rats

OBJECTIVE

The objective of this systematic review was to assess the impact of nicotine administration on orthodontic tooth movement (OTM).

METHODS

A systematic search was conducted in PubMed, Scopus, EMBASE, MEDLINE (OVID) and Web of Knowledge databases and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies evaluating the influence of nicotine on OTM, and with the presence of a control group (OTM without nicotine administration), were included. Quality assessment of the selected studies was performed following the Animal Research Reporting in Vivo Experiment (ARRIVE) guidelines.

RESULTS

Six of the initially identified 108 articles fulfilled the inclusion criteria and were selected. All included studies were performed in male rats, which underwent OTM with or without nicotine administration. Since there was a variation among the included studies regarding nicotine dosage and the duration and magnitude of force application during OTM only a qualitative analysis could be performed. The studies reported that nicotine administration accelerated OTM by inducing alveolar bone resorption around the moving teeth. It was also found that nicotine increased root resorption during experimental OTM. More standardized animal research or clinical studies are warranted to further evaluate the impact of nicotine on OTM.

CONCLUSIONS

On an experimental level, nicotine exposure in rats jeopardizes OTM by increasing alveolar bone loss and root resorption. From a clinical perspective, further studies are needed to assess the impact of habitual use of tobacco products on OTM.