Effects of relaxin on collagen type I released by stretched human periodontal ligament cells

Periodontal response to nonsurgical accelerated orthodontic tooth movement

Tooth movement is a complex process involving the vascularization of the tissues, remodeling of the bone cells, and periodontal ligament fibroblasts under the hormonal and neuronal regulation mechanisms in response to mechanical force application. Therefore, it will inevitably impact periodontal tissues. Prolonged treatment can lead to adverse effects on teeth and periodontal tissues, prompting the development of various methods to reduce the length of orthodontic treatment. These methods are surgical or nonsurgical interventions applied simultaneously within the orthodontic treatment. The main target of nonsurgical approaches is modulating the response of the periodontal tissues to the orthodontic force. They stimulate osteoclasts and osteoclastic bone resorption in a controlled manner to facilitate tooth movement. Among various nonsurgical methods, the most promising clinical results have been achieved with photobiomodulation (PBM) therapy. Clinical data on electric/magnetic stimulation, pharmacologic administrations, and vibration forces indicate the need for further studies to improve their efficiency. This growing field will lead to a paradigm shift as we understand the biological response to these approaches and their adoption in clinical practice. This review will specifically focus on the impact of nonsurgical methods on periodontal tissues, providing a comprehensive understanding of this significant and understudied aspect of orthodontic care.

Effects of mechanical loading on matrix homeostasis and differentiation potential of periodontal ligament cells: A scoping review

Various mechanical loadings, including mechanical stress, orthodontics forces, and masticatory force, affect the functions of periodontal ligament cells. Regulation of periodontal tissue destruction, formation, and differentiation functions are crucial processes for periodontal regeneration therapy. Numerous studies have reported that different types of mechanical loading play a role in maintaining periodontal tissue matrix homeostasis, and osteogenic differentiation of the periodontal ligament cells. This scoping review aims to evaluate the studies regarding the effects of various mechanical loadings on the secretion of extracellular matrix (ECM) components, regulation of the balance between formation and destruction of periodontal tissue matrix, osteogenic differentiation, and multiple differentiation functions of the periodontal ligament. An electronic search for this review has been conducted on two databases; MEDLINE via PubMed and SCOPUS. Study selection criteria included original research written in English that reported the effects of different mechanical loadings on matrix homeostasis and differentiation potential of periodontal ligament cells. The final 204 articles were mainly included in the present scoping review. Mechanical forces of the appropriate magnitude, duration, and pattern have a positive influence on the secretion of ECM components such as collagen, as well as regulate the secretion of matrix metalloproteinases and tissue inhibitors of matrix metalloproteinases. Additionally, these forces regulate a balance between osteoblastic and osteoclast differentiation. Conversely, incorrect mechanical loadings can lead to abnormal formation and destruction of both soft and hard tissue. This review provides additional insight into how mechanical loadings impact ECM homeostasis and multiple differentiation functions of periodontal ligament cells (PDLCs), thus making it valuable for regenerative periodontal treatment. In combination with advancing technologies, the utilization of ECM components, application of different aspects of mechanical force, and differentiation potential of PDLCs could bring potential benefits to future periodontal regeneration therapy.

Antifibrotic effects of sulforaphane treatment on gingival elasticity reduces orthodontic relapse after rotational tooth movement in beagle dogs

Objective

Increased gingival elasticity has been implicated as the cause of relapse following orthodontic rotational tooth movement and approaches to reduce relapse are limited. This study aimed to investigate the effects of sulforaphane (SFN), an inhibitor of osteoclastogenesis, on gene expression in gingival fibroblasts and relapse after rotational tooth movement in beagle dogs.

Methods

The lower lateral incisors of five beagle dogs were rotated. SFN or dimethylsulfoxide (DMSO) were injected into the supra-alveolar gingiva of the experimental and control group, respectively, and the effect of SFN on relapse tendency was evaluated. Changes in mRNA expression of extracellular matrix components associated with gingival elasticity in beagles were investigated by real-time polymerase chain reaction. Morphology and arrangement of collagen fibers were observed on Masson's trichrome staining of buccal gingival tissues of experimental and control teeth.

Results

SFN reduced the amount and percentage of relapse of orthodontic rotation. It also decreased the gene expression of lysyl oxidase and increased the gene expression of matrix metalloproteinase (MMP) 1 and MMP 12, compared with DMSO control subjects. Histologically, collagen fiber bundles were arranged irregularly and were not well connected in the SFN-treated group, whereas the fibers extended in parallel and perpendicular directions toward the gingiva and alveolar bone in a more regular and well-ordered arrangement in the DMSO-treated group.

Conclusions

Our findings demonstrated that SFN treatment may be a promising pharmacologic approach to prevent orthodontic rotational relapse caused by increased gingival elasticity of rotated teeth in beagle dogs.

The Potential Use of Pharmacological Agents to Modulate Orthodontic Tooth Movement (OTM)

The biological processes that come into play during orthodontic tooth movement (OTM) have been shown to be influenced by a variety of pharmacological agents. The effects of such agents are of particular relevance to the clinician as the rate of tooth movement can be accelerated or reduced as a result. This review aims to provide an overview of recent insights into drug-mediated effects and the potential use of drugs to influence the rate of tooth movement during orthodontic treatment. The limitations of current experimental models and the need for well-designed clinical and pre-clinical studies are also discussed.

Mechano-regulation of collagen biosynthesis in periodontal ligament

Periodontal ligament (PDL) plays critical roles in the development and maintenance of periodontium such as tooth eruption and dissipation of masticatory force. The mechanical properties of PDL are mainly derived from fibrillar type I collagen, the most abundant extracellular component. The biosynthesis of type I collagen is a long, complex process including a number of intra- and extracellular post-translational modifications. The final modification step is the formation of covalent intra- and intermolecular cross-links that provide collagen fibrils with stability and connectivity. It is now clear that collagen post-translational modifications are regulated by groups of specific enzymes and associated molecules in a tissue-specific manner; and these modifications appear to change in response to mechanical force. This review focuses on the effect of mechanical loading on collagen biosynthesis and fibrillogenesis in PDL with emphasis on the post-translational modifications of collagens, which is an important molecular aspect to understand in the field of prosthetic dentistry.

Detection of relaxin receptor in the dorsoradial ligament, synovium, and articular cartilage of the trapeziometacarpal joint

Basilar thumb osteoarthritis (OA) is postulated to occur due to ligament attenuation of the trapeziometacarpal (TM) joint. Relaxin is a peptide hormone, which loosens ligaments before childbirth, through remodeling of the extracellular matrix via upregulation of matrix metalloproteases (MMPs). We postulated that relaxin family peptide receptor 1 (RXFP-1), the receptor for circulating relaxin, was present in tissues of the TM joint. Ligaments and synovium were sampled from 15 patients during surgery for TM arthritis. We obtained trapezial cartilage from two autopsy donors and four patients. Tissues were fixed, paraffin embedded, and sectioned at 5 µm, then were immunostained for RXFP-1, as well as MMP-1, and MMP-13, using rabbit anti-human polyclonal antibodies. Eight DRL samples showed positive immunostaining for relaxin receptor, with 14/15 positively stained in synovium. Greater staining was seen in specimens obtained from women with more severe TM arthritis. Trapezial cartilage demonstrated receptor staining within chondrocytes in the middle and deep zones. Immunostaining for MMPs co-localized with relaxin receptor staining. Relaxin receptors are present at the ligament, cartilage, and synovium of the TM joint, indicating that it is a potential target for relaxin. This suggests that circulating relaxin may impact joint stability. The role of relaxin in cartilage and synovium may be related to its role in collagen regulation as a possible tissue response to OA.

Down-regulation of collagen synthesis and matrix metalloproteinase expression in myofibroblasts from Dupuytren nodule using adenovirus-mediated relaxin gene therapy

Dupuytren's disease is a fibroproliferative connective tissue disorder characterized by contracture of the palmer fascia of the hand. Relaxin (RLN) is a multifunctional factor which contributes to the remodeling of the pelvic ligament by inhibiting fibrosis and inflammatory activities. The aim of this study was to investigate the effect of the RLN gene on the inhibition of fibrosis in myofibroblastic cells. Myofibroblast cells with adenovirus LacZ (Ad-LacZ) as a marker gene or adenovirus relaxin (Ad-RLN) as therapeutic gene showed transgene expressions in beta-galactosidase assay and Western blot analysis. Myofibroblastic cells with Ad-RLN demonstrated a 22% and 48% reduction in collagen I and III mRNA expressions respectively, a 50% decrease in MMP-1, 70% decrease in MMP-2, 80% decrease in MMP-9, and a 15% reduction in MMP-13 protein expression compared with cultures with viral control and saline control. In addition, myofibroblastic cells with Ad-RLN showed a 40% decrease in TIMP 1 and a 15% increase in TIMP 3 protein expression at 48 h compared to cultures with viral control and saline control. Also, myofibroblastic cell with Ad-RLN demonstrated a 74% inhibition of fibronectin and a 52% decrease in total collagen synthesis at 48 h compared with cultures with viral control and saline control. In conclusion, the RLN gene render antifibrogenic effect on myofibroblastic cells from Dupuytren's nodule via direct inhibition of collagen synthesis not through collagenolytic pathway such as MMP-1, -13, TIMP 1, and 3. Therefore relaxin can be an alternative therapeutic strategy in initial stage of Dupuytren's disease by its antifibrogenic effect.

Osteogenic differentiation of periodontal fibroblasts is dependent on the strength of mechanical strain

OBJECTIVE

During orthodontic therapy the correct strength of mechanical strain plays a key role for bone remodelling during tooth movement. Aim of this study was to investigate the osteogenic differentiation of human periodontal ligament fibroblasts (HPdLF) depending on the applied strength of mechanical strain compared to osteoblasts (HOB).

DESIGN

HPdLF and HOB were loaded with different strengths (1%, 5% and 10%) of static mechanical strain (SMS) for 12h in vitro. Viability was verified by MTT and apoptosis by TUNEL assay. Gene expression of cyclin D1, collagen type-1 (COL-I), alkaline phosphatase (ALP), osteocalcin, osteoprotegerin (OPG) and receptor activator of the NF-κB ligand (RANKL) were investigated using RT-PCR. OPG and RANKL synthesis was measured by ELISA and ALP activity by colorimetric assay.

RESULTS

10% of SMS led to a decrease in cell viability of both cells lines, but no increased rate of apoptosis. RT-PCR showed the highest increase of cyclin D1 expression for HPdLF and HOB when applied to 5% of SMS, and HOB showed a doubling of COL-I gene expression. HPdLF and HOB showed a strength-dependent synthesis of OPG and ALP activity, whereas HOB demonstrated a decrease in OPG synthesis and ALP activity when applied to 10% of SMS.

CONCLUSION

Osteogenic differentiation of HPdLF correlates with increasing strength of SMS. HOB show decreased activity when applied to high SMS, demonstrating potential damage to the bone remodelling due to strain of high strength. SMS up to 5% provides the best conditions for bone formation at the tension site of tooth movement.

Effects of low-intensity laser therapy on periodontal tissue remodeling during relapse and retention of orthodontically moved teeth

This study was designed to investigate the effects of low-intensity laser therapy (LILT) on periodontal ligament (PDL) remodeling during relapse and retention after the completion of orthodontic movement. The maxillary central incisors (n = 104) of the 52 rats were randomly divided into five groups according to the treatment modality: baseline control group without any intervention (n = 8); relapse group without retainer after tooth movement (n = 24); retention group with fixed retainer after tooth movement (n = 24); lased relapse group without retainer after tooth movement and LILT (n = 24); lased retention group with retainer after tooth movement and LILT (n = 24). LILT was daily performed using a gallium-aluminum-arsenide diode laser in a biostimulation mode: wavelength of 780 nm, continuous waves at 70 mW output power, a preset low intensity of 1.75 W/cm(2) in contact mode, resulting in energy dose of 5 J/cm(2) per irradiation for 3 s. The animals were euthanized on days 1, 3, and 7 after removal of the orthodontic appliance. Real-time RT-PCR was performed for quantitative analysis of matrix metalloproteinases mRNA expression. Immunoreactivities of collagen and tissue inhibitor of metalloproteinase were observed on the compression and tension sides. LILT significantly facilitated the expression of five tested MMP mRNAs in both relapse and retention groups. TIMP-1 immunoreactivity was inhibited by LILT in both groups, whereas Col-I immunoreactivity was increased by LILT only in the retention group. These results indicate that LILT would act differently on the stability after orthodontic treatment according to additional retainer wearing or not. LILT when combined with a retainer on the moved teeth may shorten the retention period by accelerating periodontal remodeling in the new tooth position, whereas, LILT on the moved teeth left without any retainer would rather increase the rate of relapse after treatment.

A randomized, placebo-controlled clinical trial on the effects of recombinant human relaxin on tooth movement and short-term stability

INTRODUCTION

Moving teeth rapidly and avoiding posttreatment relapse are fundamental goals of orthodontic treatment. In-vitro and animal studies suggest that the human hormone relaxin might increase the rate of movement and the stability through its effect on the periodontal ligament. The purpose of this study was to compare relaxin and a placebo with regard to tooth movement and stability in human subjects.

METHODS

A single-center, blinded, placebo-controlled, randomized clinical trial was used to examine the effect of relaxin on tooth movement and stability. Forty subjects were randomized 1:1 and received weekly injections of 50 μg of relaxin or a placebo for 8 weeks. Aligners programmed to move a target tooth 2 mm during treatment were dispensed at weeks 0, 2, 4, and 6. Movement was measured weekly on polyvinyl siloxane impressions that were scanned and digitized. The subjects were followed through week 12 to assess relapse.

RESULTS

Tooth movement over the 8-week treatment period did not differ by treatment group (P = 0.995). By using an intent-to-treat analysis, we found that the mean tooth movement for both groups was 0.83 mm (SE, 0.08 for relaxin and 0.09 for the placebo). Relapse from weeks 8 to 12 was the same in both groups (P = 0.986), and the mean was -0.75 (SE, 0.07 for relaxin and 0.08 for theplacebo).

CONCLUSIONS

No differences in tooth movement over 8 weeks of treatment or relapse at 4 weeks posttreatment were detected when comparing subjects who received weekly injections of relaxin with those who received a placebo. In both groups, an average of less than half of the programmed tooth movement was obtained after 8 weeks of treatment. The local doses of relaxin might have been too low to affect tooth movement or short-term relapse.

Effects of relaxin on relapse and periodontal tissue remodeling after experimental tooth movement in rats

The relapse of teeth that have moved during orthodontic treatment is a major clinical issue with respect to the goals of successful treatment. Relaxin has an influence on many physiologic processes, such as collagen turnover. In this study, we determined the effects of relaxin on the relapse and remodeling of periodontal tissue after experimental tooth movement in rats, and we explored the molecular mechanism underlying these processes. To induce experimental tooth movement in rats, 10 g of orthodontic force was applied to the molars. After 14 days, the spring was removed, and then animals began receiving relaxin at a dose of 500 ng/ml for 1 week. The results were evaluated by micro-computed tomography and immunofluorescence staining. In addition, the effects of matrix metalloproteinase (MMP)-1 and MMP-8 production were investigated in human periodontal ligament (hPDL) cells in vitro. The expression of MMP-1 and MMP-8 was analyzed by real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Furthermore, we demonstrated the signaling pathways involved in relaxin-regulated MMPs expression. The relapse distances and percentages were significantly decreased in the experimental group compared with the controls in vivo. A double-immunofluorescence analysis for Col-I/MMP-1 and Col-I/MMP-8 detected the expression of relaxin in the PDL. Relaxin significantly increased the MMP-1 and MMP-8 expression in a time-dependent manner in hPDL cells in vitro. Furthermore, a p38 inhibitor (SB203580) significantly inhibited the MMP-1 and MMP-8 expression. Our results indicated that relaxin modulates the collagen metabolism, and this hormone may therefore be useful to prevent orthodontic relapse following orthodontic treatment.

Involvement of JNK-AP-1 and ERK-NF-κB signaling in tension-stimulated expression of Type I collagen and MMP-1 in human periodontal ligament fibroblasts

Type I collagen (COL I) and matrix metalloproteinase-1 (MMP-1) are the predominant matrix proteins in the extracellular matrix of the human periodontal ligament (PDL). The expression of these proteins in PDL fibroblasts (PLF) is sensitive to physiological and mechanical stress and is critical for PDL remodeling accompanied by alveolar bone remodeling. This study examined how dose tensile force regulates the expression of COL I and MMP-1 and explored the possible roles of mitogen-activated protein kinases (MAPKs) and transcription factors, such as activator protein-1 (AP-1) and nuclear factor-κB (NF-κB). Tensile force stimulated the mRNA expression of COL I and MMP-1 in the cells and also activated MAPKs including extracellular signal-regulated kinase (ERK), c-Jun NH2-terminal kinase (JNK), and p38 MAPK. A pharmacological inhibitor of ERK or JNK prevented the expression of matrix genes and the nuclear translocation of c-Jun proteins in the force-applied PLF. The knockdown of c-Jun by transfecting the cells with its antisense oligonucleotides reduced the force-induced increase in matrix gene expression. In particular, the ERK inhibitor but not JNK or p38 MAPK inhibitor attenuated the force-mediated stimulation of NF-κB-DNA binding and MMP-1 expression. Overall, these results highlight the mechanotransduction pathways involved in matrix gene expression in PLF, where the tension-stimulated expression of COL I and MMP-1 is controlled by the ERK/JNK-AP-1 and ERK-NF-κB signaling pathways.