Differential Efficacy of 2 Vibrating Orthodontic Devices to Alter the Cellular Response in Osteoblasts, Fibroblasts, and Osteoclasts

Effectiveness of low frequency vibration on the rate of canine retraction: a randomized controlled clinical trial

To investigate the effectiveness of AcceleDent Aura vibrating device on the rate of canine retraction. Thirty-two patients requiring extraction of upper first premolars and canine retraction were randomly allocated with a 1:1 ratio into either no-appliance group or the AcceleDent Aura appliance group. Canine retraction was done applying 150gm of retraction force using NiTi coil springs on 16 × 22 stainless steel archwires. The duration of the study was 4 months. Models were collected and digitized directly after extraction of upper first premolars and at monthly intervals during canine retraction for recording the monthly as well as the total distance moved by the canine. Digitized models were superimposed on the initial model and data were statistically analyzed. Anchorage loss, rotation, tipping, torque and root condition were evaluated using cone beam computed tomography imaging. Pain was evaluated by visual analog scale. No patients were dropped-out during this study. There was no statistically significant difference between both groups regarding the total distance travelled by the canine (P = 0.436), as well as the rate of canine retraction per month (P = 0.17). Root condition was the same for the two groups. Regarding the pain level, there was no statistically significant difference between the two groups at day 0 (P = 0.721), after 24 h (P = 0.882), after 72 h (P = 0.378) and after 7 days (P = 0.964). AcceleDent Aura was not able to accelerate orthodontic tooth movement. Pain level couldn't be reduced by vibrational force with an AcceleDent device during orthodontic treatment. Root condition was not affected by the vibrational forces.

The effect of physical interventions on pain control after orthodontic treatment: A systematic review and network meta-analysis

OBJECTIVE

Pain is a frequent adverse reaction during orthodontic treatment, which can significantly reduce treatment compliance and compromise the expected treatment effect. Physical interventions have been used to alleviate pain after orthodontic treatment, but their effectiveness is controversial. This study used a network meta-analysis to assess the efficacy of various physical interventions typically used in managing pain after orthodontic treatment, with a view to provide evidence-based recommendations for representative interventions for orthodontic pain relief during peak pain intensity.

METHODS

A systematic search of six electronic databases, from their respective inception dates, was conducted to identify relevant literature on the efficacy of various typical physical interventions for managing pain after orthodontic treatment. Literature screening was performed according to the Cochrane System Evaluator's Manual. Stata 16.0 was used to assess heterogeneity, inconsistency, publication bias, and sensitivity to generate an evidence network diagram and conduct a network meta-analysis.

RESULTS

In total, 771 articles were reviewed to collect literature on interventions, including low-level laser therapy (LLLT), vibration, acupuncture, and chewing. Of these, 28 studies using a visual analog scale (VAS) as an outcome indicator were included. The results showed that LLLT, vibration, acupuncture, and chewing effectively relieved the pain symptoms in patients after orthodontic treatment. At 24 h post-treatment, LLLT (surface under the cumulative ranking curve [SUCRA] = 80.8) and vibration (SUCRA = 71.1) were the most effective interventions. After 48 h of treatment, acupuncture (SUCRA = 89.6) showed a definite advantage as the best intervention.

CONCLUSION

LLLT, vibration, acupuncture, and chewing can alleviate pain associated with orthodontic treatment. Among these interventions, acupuncture was found to be the most effective at 48 h after orthodontic treatment. In addition, acupuncture demonstrated long-lasting and stable pain-relieving effects. However, further studies are needed to determine the most suitable equipment-specific parameters for acupuncture in relieving pain associated with orthodontic treatment.

Utilization of Low-Magnitude High-Frequency Vibration (LMHFV) as an Aid in Treating Peri-Implantitis: Case Presentations

Peri-implantitis is an inflammatory process initiating in the soft tissue and then progressing to the hard tissue surrounding dental implants leading to loss of osseous support and potential loss of the implant if not identified early in the process. This process initiates in the soft tissue, which become inflamed spreading to the underlying bone leading to decreases in bone density with subsequent crestal resorption and thread exposure. In the absence of treatment of the peri-implantitis, the bone loss at the osseous implant interface progresses with inflammatory mediated decrease in the bone density that moves apically, eventually leading to mobility of the implant and its failure. Low-magnitude high-frequency vibration (LMHFV) has been shown to improve bone density, stimulate osteoblastic activity, and arrest progression of peri-implantitis with improvement of the bone or graft around the affected implant with or without surgery as part of the treatment. Two cases are presented using LMHFV to augment treatment.

Effects of different physical factors on osteogenic differentiation

Osteoblasts are essential for bone formation and can perceive external mechanical stimuli, which are translated into biochemical responses that ultimately alter cell phenotypes and respond to environmental stimuli, described as mechanical transduction. These cells actively participate in osteogenesis and the formation and mineralisation of the extracellular bone matrix. This review summarises the basic physiological and biological mechanisms of five different physical stimuli, i.e. light, electricity, magnetism, force and sound, to induce osteogenesis; further, it summarises the effects of changing culture conditions on the morphology, structure and function of osteoblasts. These findings may provide a theoretical basis for further studies on bone physiology and pathology at the cytological level and will be useful in the clinical application of bone formation and bone regeneration technology.

Mechanical vibration as an adjunct to clear aligner treatment for accelerating tooth movement: A review

Many patients, particularly adults, may prefer clear aligner treatment due to its esthetics and ease of use. Some studies have shown that mechanical vibration can affect the rate of tooth movement and other aspects of orthodontic treatment. The purpose of this systematic review was to substantiate the effects of vibration as an adjunct to clear aligner treatment. A comprehensive search of the PubMed, Embase, Cochrane library, and Scopus and also hand searching of reference lists was conducted for finding published studies up to March 2021. Two authors reviewed the titles and abstracts independently to select relevant studies and the full texts where there was some skepticism. Seven papers were included in this study following removing duplicates and irrelevant studies, four of which were randomized controlled trial and three were retrospective studies. In the majority of studies, High-Frequency Vibration (HFV) has shown to be effective in accelerating tooth movement and reducing the exchange interval of aligners. Little data have advocated that HFV can increase bone density, reduce pain or root resorption. It seems that HFV is more effective than low frequency vibration in patients treated with clear aligners. Based on a low level of certainty, HFV can increase the rate of tooth movement and decrease the exchange interval of clear aligners. Further investigation is necessary to clarify the effects of vibration on pain and discomfort, bone density, and root resorption.

EFFECTIVENESS OF VIBRATION (CYCLIC LOADING) IN ACCELERATING BONE REMODELING AND ORTHODONTIC TOOTH MOOVEMENT: A SHORT REVIEW

This paper assesses the effectiveness of vibration in accelerating bone remodeling and orthodontic tooth movement. Databases of PubMed, Web of Science, and ScienceDirect were searched from January 2017 to March 2019 for randomized or quasi-randomized controlled trials that evaluated the effectiveness of vibration in accelerating bone remodeling and orthodontic tooth movement. The inclusion criteria were as follows: (i) studies that assessed the efficacy of vibration (cyclic loading) in bone remodeling and orthodontic tooth movement and (ii) those that employed groupings (experimental vs. control/placebo groups) on the basis of the use of vibration (cyclic loading). Eight clinical trials were included in this short review. Five studies met the eligibility criteria for bone remodeling and orthodontic tooth movement. Four studies found that low-magnitude high-frequency vibration could accelerate bone remodeling. However, contradictory results were obtained with regard to the acceleration of orthodontic tooth movement by vibration in human participants. Low-magnitude high-frequency vibration can accelerate bone remodeling and orthodontic tooth movement. However, this acceleration is dependent on the magnitude and frequency. Further research is necessary to determine the most feasible protocols for investigating the effects of magnitude and frequency of vibration on the acceleration of orthodontic tooth movement in human participants.

Impact of Vibration on the Levels of Biomarkers: A Systematic Review

Introduction:

The objective of this systematic review is to assess the effect of vibrational force on biomarkers for orthodontic tooth movement.

Methods:

An electronic search was conducted for relevant studies (up to December 31, 2020) on the following databases: Pubmed, Google scholar, Web of Science, Cochrane Library, Wiley Library, and ProQuest Dissertation Abstracts and Thesis database. Hand searching of selected orthodontic journals was also undertaken. The selected studies were assessed for the risk of bias in Cochrane collaboration risk of bias tool. The “traffic plot” and “weighted plot” risk of bias distribution are designed in the RoB 2 tool. The 2 authors extracted the data and analyzed it.

Results:

Six studies fulfilled the inclusion criteria. The risks of biases were high for 4, low and some concern for other 2 studies. The biomarkers, medium, device, frequency and duration of device, as well as other data were extracted. The outcomes of the studies were found to be heterogenous.

Conclusion:

One study showed highly statistically significant levels of IL-1 beta with <.001. Rate of tooth movement was correlated with levels of released biomarkers under the influence of vibrational force in 3 studies, but it was found to be significant only in 1 study. It was further observed that vibration does not have any significant reduction in pain and discomfort.

Impact of photobiomodulation and low-intensity pulsed ultrasound adjunctive interventions on orthodontic treatment duration during clear aligner therapy: A retrospective study

OBJECTIVE

To assess the efficiency of low-intensity pulsed ultrasound (LIPUS) and photobiomodulation (PBM) interventions in accelerating orthodontic tooth movement during clear aligner therapy (CAT).

MATERIALS AND METHODS

This retrospective study was carried out on the records of 84 subjects who were treated using CAT. Twenty-eight patients were treated using CAT with a daily use of LIPUS for 20 minutes, 28 patients were treated using CAT with a daily use of PBM for 10 minutes, and 28 patients were treated using CAT alone. The total duration of treatment was recorded for all patients. One-way analysis of variance and post hoc Tukey test were used to assess whether there was any significant difference in total treatment duration among the three groups (P < .05).

RESULTS

The mean treatment durations in days were 719 ± 220, 533 ± 242, and 528 ± 323 for the control, LIPUS, and PBM groups, respectively. The LIPUS group showed a 26% reduction, on average, in treatment duration when compared with the control group, whereas the PBM group showed an average 26.6% reduction in the treatment duration when compared with the control group. The results showed that there were statistically significant differences among the groups (P = .011). Treatment durations were significantly reduced in the LIPUS and PBM groups as compared with the control (P = .027 and P = .023, respectively), with no statistically significant differences between the LIPUS and PBM groups (P = .998).

CONCLUSIONS

Daily use of LIPUS or PBM as adjunctive interventions during CAT could reduce the duration of orthodontic treatment.

Effects of Physical Stimulation in the Field of Oral Health

Physical stimulation has been widely used in clinical medicine and healthcare due to its noninvasiveness. The main applications of physical stimulation in the oral cavity include laser, ultrasound, magnetic field, and vibration, which have photothermal, cavitation, magnetocaloric, and mechanical effects, respectively. In addition, the above four stimulations with their unique biological effects, which can play a role at the gene, protein, and cell levels, can provide new methods for the treatment and prevention of common oral diseases. These four physical stimulations have been used as important auxiliary treatment methods in the field of orthodontics, implants, periodontal, dental pulp, maxillofacial surgery, and oral mucosa. This paper systematically describes the application of physical stimulation as a therapeutic method in the field of stomatology to provide guidance for clinicians. In addition, some applications of physical stimulation in specific directions are still at the research stage, and the specific mechanism has not been fully elucidated. To encourage further research on the oral applications of physical stimulation, we elaborate the research results and development history of various physical stimuli in the field of oral health.

Evaluation of the effects of diode laser application on experimental orthodontic tooth movements in rats. Histopathological analysis

Purpose:

To evaluate the effect of diode laser use on experimental orthodontic tooth movements.

Methods:

Thirty Rattus norvegicus albinus Wistar were divided into three equal groups (n = 10), two experimentals and one control. Applying 20 g orthodontic force were attached to the maxillary incisors of the rats in all groups. Low dose laser was applied to the surrounding tissues of the maxillary incisors of the rats in the experimental groups. Two exposure times for laser irradiation were used for seven days: t = 12 min (energy dose = 72 J) and t = 9 min (energy dose = 54 J) by a 0.1 W DEKA brand diode laser with wavelength of 980 nm.

Results:

Osteoclastic activation increased in the 72 J group when compared to control group and decreased in comparison to the 54 J group. Osteoblastic activation was decreased in the 72 J group when compared to the control group and increased in comparison to the 54 J group.

Conclusions:

Applying 54 J laser energy has been found effective to accelerate the orthodontic tooth movement.

Vibration synergistically enhances IL-1β and TNF-α in compressed human periodontal ligament cells in the frequency-dependent manner

Objectives

To investigate whether mechanical vibration at 30 or 60 Hz combined with compressive force alter IL-1β and TNF-α expression in human periodontal ligament (hPDL) cells.

Methods

hPDL cells isolated from the roots of first premolar teeth extracted from four independent donors were cultured and exposed to vibration (0.3 g, 20 min per cycle, every 24 h for 3 cycles) at 30 or 60 Hz (V30 or V60), 2.0 g/cm² compressive force for 2 days (CF), or a combination of compressive force and vibration at 30 Hz or 60 Hz (V30CF or V60CF). Quantitative real-time polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assays (ELISAs) were used to determine IL-1β and TNF-α mRNA and protein, respectively.

Results

The levels of IL-1β and TNF-α did not alter in groups V30 and V60. While, they were upregulated in groups CF, V30CF and V60CF. In addition, IL-1β mRNA and TNF-α mRNA and protein were expressed at significantly higher levels in group V30CF compared to CF group. However, IL-1β protein levels between V30CF and CF groups did not reach statistical significance.

Conclusions

30 Hz vibration had the synergistic effects with compressive force on the upregulation of IL-1β mRNA and TNF-α mRNA and protein in PDL cells, while 60 Hz vibration did not have this synergistic effect.

Vibration activates the actin/NF-κB axis and upregulates IL-6 and IL-8 expression in human periodontal ligament cells

We previously reported that mechanical vibration-induced proinflammatory cytokines, interleukin-6 (IL-6) and IL-8, expression in human periodontal ligament (hPDL) cells, however, the underlying mechanism remained unclear. Mechanical stimuli are able to activate cellular responses by inducing the activation of several signaling pathways including cytoskeletal changes and inflammation. The actin cytoskeleton is a highly dynamic network and plays many important roles in intracellular events. Here, we aimed to investigate the involvement of a pivotal mediator of inflammatory responses, nuclear factor-κB (NF-κB), and actin polymerization in vibration-induced upregulation of IL-6 and IL-8 expression in hPDL cells. hPDL cells were pretreated with the NF-κB inhibitor BAY 11-7082 or cytochalasin D, respectively, before exposure to vibration. IL-6 and IL-8 messenger RNA (mRNA) and protein expression were quantified by quantitative polymerase chain reaction and enzyme-linked immunosorbent assays, respectively. Subcellular localization of the NF-κB p65 subunit was visualized by immunofluorescent staining. We found an increase in NF-κB nuclear translocation in vibrated cells compared with control cells. Pretreatment with BAY 11-7082 significantly inhibited vibration-induced IL-6 and IL-8 mRNA and protein expression in hPDL cells. Moreover, pretreatment with cytochalasin D inhibited NF-κB nuclear translocation and attenuated upregulation of IL-6 and IL-8 mRNA and protein in vibrated cells. Therefore, modulation of actin cytoskeletal polymerization in response to vibration may activate the NF-κB signaling pathway and subsequently upregulate IL-6 and IL-8 expression in hPDL cells.

Effect of high-frequency vibration on orthodontic tooth movement and bone density

OBJECTIVES:

Previous reports have shown that high-frequency vibration can increase bone remodeling and accelerate tooth movement. The aim of this study was to evaluate the effects of high-frequency vibration on treatment phase tooth movement, and post-treatment bone density at initiation of retention, with cone-beam computed tomography (CBCT).

MATERIALS AND METHODS:

Thirty patients with initial Class I skeletal relationships, initial minimum-moderate crowding (3–5 mm), treated to completion with clear aligners and adjunctive high-frequency vibration, (HFV group) or no vibration, (Control group) were evaluated. The patients were instructed to change aligners as soon as they become loose. Changes in bone density associated with orthodontic treatment were evaluated using i-CAT cone-beam computed tomography (CBCT) and InVivo Anatomage^® software to quantify density using Hounsfield units (HU) between treated teeth in 10 different regions. HU values were averaged and compared against baseline (T1) and between the groups at initiation of retention (T2).

RESULTS:

The average time for aligner change was 5.2 days in the HFV group, and 8.7 days in the control group (P = 0.0001). There was significant T1 to T2 increase of HU values in the upper arch (P = 0.0001) and the lower arch (P = 0.008) in the HFV group. There was no significant change in average HU values in the upper (P = 0.83) or lower arches (P = 0.33) in the control group. The intergroup comparison revealed a significant difference in the upper, (P = 0.0001) and lower arches (P = 0.007).

CONCLUSION:

High-frequency vibration adjunctive to clear aligners, allowed early aligner changes that led to shorter treatment time in minimum-moderate crowded cases. At initiation of retention, the HFV group demonstrated statistically significant increase as compared with pre-treatment bone density, whereas control subjects showed no significant change from pre-treatment bone density.