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Martin C, Sanz M. Orthodontic tooth movement after periodontal regeneration of intrabony defects. Korean J Orthod 2024; 54:3-15. [PMID: 38268459 PMCID: PMC10811355 DOI: 10.4041/kjod24.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/26/2024] Open
Abstract
The prevalence of intrabony defects in patients with advanced periodontitis stages III and IV is high. These patients usually need both periodontal treatment and orthodontic therapy, including tooth movement through bone defects, to improve masticatory function, aesthetics, and overall quality of life. Clinical practice guidelines recommend periodontal regenerative surgical interventions to resolve these defects and propose initiating orthodontic tooth movement (OTM) once periodontal therapy goals have been met. Surgical interventions using various regenerative technologies like barrier membranes and enamel matrix proteins, combined or not with bone replacement grafts, have proven effective in regenerating lost periodontal tissues. However, the combination of periodontal and orthodontic treatments requires consideration of how periodontal regenerative therapies influence OTM. Studies suggest that regenerated bone may differ in density, composition, vascularity, and cellular activity, potentially affecting the speed and efficiency of OTM, and potential root resorption of moved teeth. Understanding the sequence and timing of implementing OTM after regenerative periodontal interventions is crucial due to their interlinked processes of bone resorption and formation. This narrative review aims to uncover scientific evidence regarding these combined treatments, examining the impacts of different regenerative technologies on OTM and delineating their advantages, limitations, and best practices.
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Affiliation(s)
- Conchita Martin
- Section of Orthodontics, Department of Dental Clinical Specialties, Complutense University of Madrid, Madrid, Spain
- BIOCRAN (Craniofacial Biology: Orthodontics and Dentofacial Orthopedics) Research Group, Complutense University of Madrid, Madrid, Spain
| | - Mariano Sanz
- Section of Orthodontics, Department of Dental Clinical Specialties, Complutense University of Madrid, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Complutense University of Madrid, Madrid, Spain
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Xu X, Peng D, Zhou B, Lin K, Wang S, Zhao W, Zheng M, Yang J, Guo J. Demineralized dentin matrix promotes gingival healing in alveolar ridge preservation of premolars extracted for orthodontic reason: a split-mouth study. Front Endocrinol (Lausanne) 2023; 14:1281649. [PMID: 37929019 PMCID: PMC10622762 DOI: 10.3389/fendo.2023.1281649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Objective The purpose of this study was to prospectively evaluate the efficacy of a demineralized dentin matrix (DDM) in decreasing the initial inflammatory response of the gingiva and facilitating the repair and regeneration of soft tissue in alveolar ridge preservation. Methods This clinical study employed a split-mouth design. Fourteen patients with a total of forty-four sites underwent extraction and alveolar ridge preservation (ARP) procedures. A Bilaterally symmetrical extraction operation were conducted on the premolars of each patient. The experimental group received DDM as a graft material for ARP, while the control group underwent natural healing. Within the first month postoperatively, the pain condition, color, and swelling status of the extraction sites were initially assessed at different time points Subsequently, measurements were taken for buccal gingival margin height, buccal-lingual width, extraction socket contour, and the extraction socket area and healing rate were digitally measured. Additionally, Alcian Blue staining was used for histological evaluation of the content during alveolar socket healing. Results Both groups experienced uneventful healing, with no adverse reactions observed at any of the extraction sites. The differences in VAS pain scores between the two groups postoperatively were not statistically significant. In the early stage of gingival tissue healing (3 days postoperatively), there were statistically significant differences in gingival condition and buccal gingival margin height between the two groups. In the later stage of gingival tissue healing (7, 14, and 30 days postoperatively), there were statistically significant differences in buccal-lingual width, extraction socket healing area, and healing rate between the two groups. Furthermore, the histological results from Alcian Blue staining suggested that the experimental group may play a significant role in promoting gingival tissue healing, possibly by regulating inflammatory responses when compared to the control group. Conclusion The application of DDM in alveolar ridge preservation has been found to diminish initial gingival inflammation after tooth extraction. Additionally, it has shown the ability to accelerate early gingival soft tissue healing and preserve its anatomical contour. Clinical trial registration chictr.org.cn, identifier ChiCTR2100050650.
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Affiliation(s)
- Xiaofeng Xu
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Stomatology, Affiliated Hospital of Putian University, Putian, China
| | - Dongsheng Peng
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Stomatology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Stomatology, Fujian Obstetrics and Gynecology Hospital, Fuzhou, China
| | - Bowei Zhou
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Kaijin Lin
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Siyi Wang
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Wei Zhao
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Minqian Zheng
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, China
| | - Jin Yang
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, China
| | - Jianbin Guo
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, China
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Zhao R, Yang R, Cooper PR, Khurshid Z, Shavandi A, Ratnayake J. Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments. Molecules 2021; 26:3007. [PMID: 34070157 PMCID: PMC8158510 DOI: 10.3390/molecules26103007] [Citation(s) in RCA: 183] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/29/2021] [Accepted: 05/13/2021] [Indexed: 02/07/2023] Open
Abstract
After tooth loss, bone resorption is irreversible, leaving the area without adequate bone volume for successful implant treatment. Bone grafting is the only solution to reverse dental bone loss and is a well-accepted procedure required in one in every four dental implants. Research and development in materials, design and fabrication technologies have expanded over the years to achieve successful and long-lasting dental implants for tooth substitution. This review will critically present the various dental bone graft and substitute materials that have been used to achieve a successful dental implant. The article also reviews the properties of dental bone grafts and various dental bone substitutes that have been studied or are currently available commercially. The various classifications of bone grafts and substitutes, including natural and synthetic materials, are critically presented, and available commercial products in each category are discussed. Different bone substitute materials, including metals, ceramics, polymers, or their combinations, and their chemical, physical, and biocompatibility properties are explored. Limitations of the available materials are presented, and areas which require further research and development are highlighted. Tissue engineering hybrid constructions with enhanced bone regeneration ability, such as cell-based or growth factor-based bone substitutes, are discussed as an emerging area of development.
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Affiliation(s)
- Rusin Zhao
- Department of Oral Science, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin 9016, New Zealand; (R.Z.); (R.Y.); (P.R.C.)
| | - Ruijia Yang
- Department of Oral Science, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin 9016, New Zealand; (R.Z.); (R.Y.); (P.R.C.)
| | - Paul R. Cooper
- Department of Oral Science, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin 9016, New Zealand; (R.Z.); (R.Y.); (P.R.C.)
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Amin Shavandi
- BioMatter Unit—École Polytechnique de Bruxelles, Université Libre de Bruxelles (ULB), Avenue F.D. Roosevelt, 50—CP 165/61, 1050 Brussels, Belgium;
| | - Jithendra Ratnayake
- Department of Oral Science, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin 9016, New Zealand; (R.Z.); (R.Y.); (P.R.C.)
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Machibya FM, Zhuang Y, Guo W, You D, Lin S, Wu D, Chen J. Effects of bone regeneration materials and tooth movement timing on canine experimental orthodontic treatment. Angle Orthod 2017; 88:171-178. [PMID: 29154676 DOI: 10.2319/062017-407] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the effects of bone regeneration materials and orthodontic tooth movement (OTM) timing on tooth movement through alveolar bone defects treated with guided bone regeneration (GBR) utilizing xenografts (Bio-Oss) and alloplast (β-TCP). MATERIALS AND METHODS Twenty-four standard alveolar bone defects in six male beagle dogs were treated by GBR using either Bio-Oss or β-TCP (experimental), whereas the control defects were left empty. The defects were further grouped into early or late subgroups, depending on OTM timing after GBR (ie 1 month or 2 months, respectively). Rates of OTM were measured intraorally, while computed tomography scan images were used to assess bone density, alveolar bone height, second premolar displacement, and tipping tendency. RESULTS Generally, the Bio-Oss early and Bio-Oss late subgroups recorded the lowest amount of tooth movement compared with other modes of GBRs assessed. Before OTM, the control group registered significantly lower bone height compared with the Bio-Oss and β-TCP groups ( P < .01). The control group was inferior on bone density and bone height compared with Bio-Oss and β-TCP. CONCLUSIONS The Bio-Oss group had favorable radiologic features (higher alveolar bone level and bone density with less premolar tipping) but showed slower OTM than the control group. The late OTM subgroup had favorable radiologic features and showed faster tooth movement than the early OTM in the β -TCP group.
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