Timing of force application on buccal tooth movement into bone-grafted alveolar defects: A pilot study in dogs

doi:10.1016/j.ajodo.2020.09.010

American Journal of Orthodontics and Dentofacial Orthopedics

Volume 159, Issue 2, February 2021, Pages e123-e134

https://doi.org/10.1016/j.ajodo.2020.09.010 Get rights and content

Highlights

•
The effect of timing of force application on bone graft regeneration was studied.
•
Force application at 4 weeks provided the best functional stimulation for a bone graft.
•
Force application at 4 weeks enhanced bone regeneration of bone substitutes.
•
Force application at 4 weeks increased bone degradation of bone substitutes.
•
Force application at 4 weeks promoted bone remodeling in the bone-grafted area.

Introduction

The aim of this pilot study was to evaluate the effect of the timing of postoperative orthodontic force application on bone remodeling during tooth movement into surgical alveolar defects with bone grafts in beagle dogs.

Methods

Six beagle dogs underwent surgery for buccal dehiscence-type defects (width, 5 mm; height, 6 mm) on the distal root of maxillary second premolars bilaterally for 12 defects. After 1-month healing, bone-augmentation procedures were undertaken at the dehiscence defects. The second premolars were protracted buccally for 6 weeks into the surgical sites immediately (F-0), at 4 weeks (F-4), or 8 weeks (F-8) after grafting. Orthodontic tooth movement was monitored using digital models. Remodeling of alveolar bone was evaluated by histology, histomorphometry, immunohistochemistry, microcomputed tomography, and fluorescence microscopy.

Results

Group F-0 showed significant expansion (mean, 2.42 mm) and tipping (mean, 9.03°) after completing orthodontic tooth treatment. The vertical bone defect was significantly lower in groups F-4 and F-8 than that in group F-0 (mean, 2.1, 2.7, and 4.5 mm, respectively). In group F-4, the formation of new bone and mineralization were significantly greater than those in groups F-0 and F-8 (P <0.05). Group F-4 showed a minimal amount of bone-material remnants. Immunohistochemistry showed the highest expression of collagen-1 and osteopontin in group F-4, followed by group F-8 and group F-0, which demonstrated high osteoblast activity and enhanced bone remodeling in group F-4.

Conclusions

Orthodontic force application at 4 weeks after an augmentation procedure provided the best functional stimulation for an alveolar bone graft. This strategy enhanced new-bone regeneration and degradation of bone substitutes and, eventually, promoted bone remodeling in the bone-grafted area.

Section snippets

Material and methods

This study was implemented and accomplished in accordance with regional Ethics Committee guidelines. The experimental protocol was approved by the Animal Experimental Ethical Committee of our hospital (HKDL[2019]502).

Six skeletally mature (1.5 years) male beagle dogs (15-16 kg) were included in the study. The surgical procedure was carried out under general anesthesia with atropine sulfate (0.04 mg/kg body weight, intramuscular [IM]), ketamine (2.5 mg/kg, IM), and a 4% solution of pentobarbital

Results

All sites showed uneventful healing without marked swelling or tissue damage after the surgical procedure.

During 6 weeks of active OF, the mean expansion of P2 was 2.42 mm in group F-0, which was significantly greater than that in group F-4 (1.25 mm) and group F-8 (1.62 mm). All groups had uncontrolled buccal tipping of the P2. The P2 tipped 9.03° ± 1.02°, 5.32° ± 2.19°, and 3.24° ± 1.27° in groups F-0, F-4, and F-8, respectively, with a significant difference between group F-0 and group F-4 (P

Discussion

As evident from the results of the present study, the null hypothesis was rejected. Compared with the other 2 groups, the group in which OF was applied 4 weeks after augmentation provided the best functional stimulation for the alveolar bone graft.

Radiography revealed no obvious repair of new bone 4 weeks after defect creation, indicating that the defect model in our study was stable. In addition, P2 was the most concave part of the buccal alveolar wall and was chosen for buccal tooth movement.

Conclusions

This report demonstrated that OF application at 4 weeks after an augmentation procedure could provide the best functional stimulation for an alveolar bone graft. This strategy promoted the degradation of bone substitutes and enhanced the formation of new bone.

Author CRediT Statement

Zhigui Ma and Zixiao Wang: conceptualization, methodology, writing—original draft preparation together; Jisi Zheng: investigation and data curation; Xinwei Chen and Weifeng Xu: visualization and resources; Duohong Zou: writing—reviewing; Shanyong Zhang and Chi Yang: supervision, writing—reviewing and editing.

References (27)

T. Mayer et al.
Localized alveolar ridge augmentation before orthodontic treatment. A case report
Int J Oral Maxillofac Surg
(1994)
K. Evangelista et al.
Dehiscence and fenestration in patients with Class I and Class II Division 1 malocclusion assessed with cone-beam computed tomography
Am J Orthod Dentofacial Orthop
(2010)
W.M. Wainwright
Faciolingual tooth movement: its influence on the root and cortical plate
Am J Orthod
(1973)
M.T. Wilcko et al.
Accelerated osteogenic orthodontics technique: a 1-stage surgically facilitated rapid orthodontic technique with alveolar augmentation
J Oral Maxillofac Surg
(2009)
H.W. Ahn et al.
Timing of force application affects the rate of tooth movement into surgical alveolar defects with grafts in beagles
Am J Orthod Dentofacial Orthop
(2014)
G. Coscia et al.
Augmented corticotomy combined with accelerated orthodontic forces in Class III orthognathic patients: morphologic aspects of the mandibular anterior ridge with cone-beam computed tomography
J Oral Maxillofac Surg
(2013)
B. Bare-Welchel et al.
Effects of bone grafting, performed with corticotomies and buccal tooth movements, on dehiscence formation in dogs
Am J Orthod Dentofacial Orthop
(2017)
B. Wang et al.
Augmented corticotomy-assisted surgical orthodontics decompensates lower incisors in Class III malocclusion patients
J Oral Maxillofac Surg
(2014)
Z.G. Ma et al.
A novel surgical technique for augmented corticotomy-assisted orthodontics: bone grafting with periosteum
J Oral Maxillofac Surg
(2016)
N.U. Zitzmann et al.
Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1998)

J. Huang et al.

Rapid maxillary expansion in alveolar cleft repaired with a tissue-engineered bone in a canine model

J Mech Behav Biomed Mater

(2015)

R.D. Rupprecht et al.

Prevalence of dehiscences and fenestrations in modern American skulls

J Periodontol

(2001)

C.S. Handelman

The anterior alveolus: its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae

Angle Orthod

(1996)

Cited by (8)

Orthodontic space management in first molar missing or unusual extraction patients
2022, AJO-DO Clinical Companion
This article aimed to describe the various clinical considerations when opening or closing first molar spaces caused by missing or extracted first molars. Orthodontic patients sometimes need unusual first molar extraction or have some missing first molars. Orthodontic treatment can manage those spaces in one of two ways: prosthetic treatment preceded by regaining orthodontic space by uprighting the adjacent teeth or orthodontic space closure without additional prostheses. To determine whether to close or open the first molar missing or extracted spaces, various factors, including adjacent periodontal status, maxillary sinus pneumatization, gingival invagination, different malocclusions, and cephalometric variables and facial treatment objectives, should be considered. The first molar missing or unusual extraction spaces should be managed with careful consideration and proper orthodontic mechanics to maximize the benefits of treatment and minimize potential risks. The chances of extraction of problematic molar vs sound premolar and molar extraction space closure with missing spaces, rather than opening spaces, increase with the development of orthodontic mechanics. Therefore, it is essential to understand the factors that determine the prognosis.
Timing of orthodontic tooth movement in bone defects repaired with synthetic scaffolds: A scoping review of animal studies
2021, Archives of Oral Biology
Citation Excerpt :
It was found that orthodontically-induced alveolar remodelling may allow earlier tooth movements into the grafted area (Araújo, Carmagnola, Berglundh, Thilander, & Lindhe, 2001a). Ma et al. (2021) reported that the rate of resorption of bone repair materials and new bone formation could be accelerated by optimum magnitude of orthodontic forces application in the direction of the grafted sites. Mechanical loading from OTM can stimulate pre-osteoblasts and mesenchymal cells to differentiate into osteoblasts.
The optimal timing of orthodontic tooth movement (OTM) could allow earlier tooth movements across alveolar bone defects while minimizing the adverse effects. The objective of this scoping systematic review was therefore designed to review pre-clinical animal studies on the ideal protocol for the timing of orthodontic traction across alveolar defects augmented with synthetic scaffolds.
Following the PRISMA-ScR guidelines, three electronic databases were searched (Pubmed, Scopus and Web of Science).
A total of twelve studies were included in the final review that reported on small-animal (rats, guinea pigs, rabbits) and large-animal (dogs and goats) models. Based on the grafting biomaterials, eight papers used cell-free scaffolds, four articles utilised cell-based scaffolds. The timing protocol for the initiation of OTM employed in the studies ranged from immediate to 6 months after surgical grafting. Only four studies included autologous bone graft (gold standard) as positive control. Most papers reported positive results with regards to the rate of OTM and bone augmentation effects while only a few reported side effects such as root resorptions. Overall, the included articles showed a massive heterogeneity in terms of the animal bone defect model characteristics, scaffold materials, study designs, parameters of OTM and methods of analysis.
Since there was inadequate evidence to identify the optimal protocol of OTM, optimization of animal bone defect models and outcome measurements is needed to improve the translational ability of future studies.
Biological Effects of Orthodontic Tooth Movement on the Periodontium in Regenerated Bone Defects: A Scoping Review
2024, Dentistry Journal
Comparison of Orthodontic Tooth Movement of Regenerated Bone Induced by Carbonated Hydroxyapatite or Deproteinized Bovine Bone Mineral in Beagle Dogs
2024, Materials
Role of periosteum in alveolar bone regeneration comparing with collagen membrane in a buccal dehiscence model of dogs
2023, Scientific Reports
Role of periosteum in alveolar bone regeneration comparing with collagen membrane in beagle dogs
2022, Research Square

View all citing articles on Scopus

: Zhigui Ma and Zixiao Wang are joint first authors and contributed equally to this work.

: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and none were reported.

: This study was supported by the National Natural Science Foundation of China (81800932, 31870969, and 81870785), Shanghai Summit and Plateau Disciplines, Science and Technology Commission of Shanghai Municipality Science Research Project (14DZ2294300), Project of Outstanding Youth Backbone of the 9th Hospital (jyyq08201601), Shanghai Municipal Hospital Emerging Frontier Technology United Key Project (SHDC12017101), and Clinical Research Project of Multi-Disciplinary Team, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine (201913).

View full text

Original articleTiming of force application on buccal tooth movement into bone-grafted alveolar defects: A pilot study in dogs

Highlights

Introduction

Methods

Results

Conclusions

Section snippets

Material and methods

Results

Discussion

Conclusions

Author CRediT Statement

Int J Oral Maxillofac Surg

Am J Orthod Dentofacial Orthop

Am J Orthod

J Oral Maxillofac Surg

Am J Orthod Dentofacial Orthop

J Oral Maxillofac Surg

Am J Orthod Dentofacial Orthop

J Oral Maxillofac Surg

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Mech Behav Biomed Mater

Prevalence of dehiscences and fenestrations in modern American skulls

J Periodontol

The anterior alveolus: its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae

Angle Orthod

Original article
Timing of force application on buccal tooth movement into bone-grafted alveolar defects: A pilot study in dogs