Influence of human parathyroid hormone during orthodontic tooth movement and relapse in the osteoporotic rat model: A preliminary study

Evaluation of mandibular bone quality with respect to enzyme inducement potential of antiepileptic drugs via fractal analysis

BACKGROUND

Epilepsy is a neurological disorder characterized by recurrent seizures and antiepileptic drug (AED) therapy is used in treatment. AED therapy have significant adverse effects as osteopenia, osteoporosis and reduced bone mineral density (BMD).

PURPOSE

The objective of this study is to evaluate the potential effects of AEDs on the trabecular of the mandible by classifying the drugs according to their ability to induce enzymes and comparing them with those of healthy people using fractal analysis.

MATERIALS AND METHODS

In this study, dental records of 70 patients (35 AED users and 35 control group) were used. Additionally, the study group was further investigated for the presence of enzyme inducing mechanism. Fractal analysis (FA), panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) measurements were performed on panoramic radiographs.

RESULTS

No statistically significant difference was observed between the study and control groups in terms of FA results and MCW, PMI and KI. There was not a statistically significant difference between AED subgroups, either.

CONCLUSION

The findings of this study indicate that the microstructural changes and panoramic morphometric indices of the mandible of AED users do not differ from those observed in healthy subjects.

CLINICAL TRIAL NUMBER

Not applicable.

Hydrolyzed egg yolk peptide alleviates ovariectomy-induced osteoporosis by regulating lipid metabolism

Osteoporosis is a systemic, progressive bone disease that causes metabolic disorders. Previous study identified the preventive effects of hydrolyzed egg yolk peptide (YPEP) on osteoporosis. However, the underlying antiosteoporosis mechanism remains unclear. Herein, 30 female rats were randomly divided into 5 groups (n = 6), including the sham, OVX, E2 (25 μg/kg/d 17β-estradiol), LYPEP (10 mg/kg/d YPEP), and HYPEP (40 mg/kg/d YPEP) groups. YPEP treatment significantly changed bone turnover marker levels and prevented the deterioration of bone structure and strength caused by ovariectomy. YPEP supplementation significantly changed endogenous metabolites related to lipid metabolism in the serum of ovariectomized rats, identifying 46 metabolites closely linked to bone biomarkers. Additionally, YPEP reduced the expression of the lipid metabolism-related protein peroxisome proliferator-activated receptor PPARγ and increased the expression of bone formation proteins BMP2 and RUNX2. Collectively, these results elucidated that YPEP improves osteoporosis by inhibiting lipogenesis to promote bone formation. This study provides novel evidence for the use of YPEP in treating osteoporosis.

Effect of anti-sclerostin antibody on orthodontic tooth movement in ovariectomized rats

BACKGROUND

This study aimed to evaluate the effect of systemically administered anti-sclerostin antibodies (Anti-Scl Ab) on orthodontic tooth movements (OTM) in an ovariectomized rat.

METHODS

Twenty-four 12-week-old female Sprague-Dawley rats were randomly divided into two groups: (1) ovariectomy (OVX) group, (2) ovariectomy + romosozumab (ROMO) group. OTM was performed 8 weeks after OVX. The ROMO group received subcutaneous injections of romosozumab twice a week, starting two weeks after OVX. Eight weeks after the OVX, an orthodontic force of 50 g was measured and applied by connecting orthodontic elastic bands between the maxillary first molar and a mini-screw to facilitate tooth movement (orthodontic treatment). Subsequently, the three rats were sacrificed on days 5, 7, 10, and 14. The plaster models were scanned to measure the amount of tooth movement. The effects on alveolar bone and periodontal tissues were evaluated through micro-computed tomography (micro-CT) analysis, tartrate-resistant acid phosphatase (TRAP) staining, and immunohistochemistry (IHC) analysis.

RESULTS

The ROMO group showed more tooth movement on day 7 of orthodontic treatment. Conversely, on days 10 and 14, relatively less movement was observed. Analysis of the root furcation area of the maxillary first molars revealed that from the 7th day, BV/TV, Tb.N., Tb.Th. increased, while Tb.Sp. decreased in the ROMO group. More TRAP-positive cells were observed in the compression side of the OVX group, the ROMO group exhibited a marked decrease in the positive expression of the RANKL, OPG, and sclerostin. The OPG/RANKL ratio showed significant differences in expression between the two groups. The ROMO group exhibited a higher OPG/RANKL ratio than the OVX group, and the tension side exhibited a higher OPG/RANKL ratio demonstrating significant differences.

CONCLUSION

Romosozumab initially accelerated tooth movements, but later decreased tooth movement. As new alveolar bone is formed, the micro-CT parameters are also improved. Osteoclasts, RANKL, OPG, and sclerostin decreased, while the OPG/RANKL ratio became higher.

Jaw osteoporosis: Challenges to oral health and emerging perspectives of treatment

Osteoporosis is a prevalent bone metabolic disease that poses a significant challenge to global human health. Jaw osteoporosis, characterized by microstructural damage of the jaw resulting from various factors, is one of the common manifestations of this condition. Recent studies have demonstrated that jaw osteoporosis has multifaceted effects on oral health and can negatively impact conditions such as periodontitis, oral implantation, orthodontic treatment, and wound healing. However, there are still some limitations in the conventional treatment of osteoporosis. For instance, while bisphosphonates can enhance bone quality, they may also lead to osteonecrosis of the jaw, which poses a potential safety hazard in oral diagnosis and treatment. In recent years, considerable attention has been focused on improving the pathological condition of jaw osteoporosis. Treatment strategies such as gut microbial regulation, extracellular vesicles, molecular targeted therapy, herbal medicine, mechanical stimulation are expected to enhance efficacy and minimize adverse reactions. Therefore, understanding these effects and exploring novel treatments for jaw osteoporosis may provide new insights for oral health maintenance and disease treatment. This article reviews the impact of jaw osteoporosis on oral health and describes the limitations associated with current methods. It also discusses emerging perspectives on treatment, offering a comprehensive overview of the challenges and future directions in managing jaw osteoporosis.

Dental implant considerations in patients with systemic diseases: An updated comprehensive review

BACKGROUND

Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise.

AIM

The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population.

METHODS

The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts.

RESULTS

In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study.

CONCLUSION

In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.

Periodontal ligament and alveolar bone remodeling during long orthodontic tooth movement analyzed by a novel user-independent 3D-methodology

The structural process of bone and periodontal ligament (PDL) remodeling during long-term orthodontic tooth movement (OTM) has not been satisfactorily described yet. Although the mechanism of bone changes in the directly affected alveolar bone has been deeply investigated, detailed knowledge about specific mechanism of PDL remodeling and its interaction with alveolar bone during OTM is missing. This work aims to provide an accurate and user-independent analysis of the alveolar bone and PDL remodeling following a prolonged OTM treatment in mice. Orthodontic forces were applied using a Ni-Ti coil-spring in a split-mouth mice model. After 5 weeks both sides of maxillae were scanned by high-resolution micro-CT. Following a precise tooth movement estimation, an extensive 3D analysis of the alveolar bone adjacent to the first molar were performed to estimate the morphological and compositional parameters. Additionally, changes of PDL were characterized by using a novel 3D model approach. Bone loss and thinning, higher connectivity as well as lower bone mineral density were found in both studied regions. Also, a non-uniformly widened PDL with increased thickness was observed. The extended and novel methodology in this study provides a comprehensive insight about the alveolar bone and PDL remodeling process after a long-duration OTM.

The Effect of Nano Calcium Carbonate and/or Recombinant Bone Morphogenetic Protein as a Biological Orthodontic Retainer on the Body Weight of Experimental Rat

BACKGROUND

Retention after orthodontic tooth movement (OTM) is essential to prevent relapse. This study examined the effects of a fixed orthodontic device and Nano Calcium Carbonate (CaCO₃) nanoparticles with or without recombinant human bone morphogenetic protein (rhBMP) on rat body weight.

MATERIALS AND METHODS

OTM was administered for 21 days to 80 Wistar Albino rats. First molar mesialization was active then forming two 40-rat groups which were subdivided into four subgroups of 10 rats each. These subgroups received 5 µg/kg rhBMP, 75 µg/kg CaCO₃, 80 µg/kg rhBMP-loaded CaCO₃ and one control. The relapse rate was examined weekly over the second 21 days when the second group exhibited mechanical retention and the first did not. Group 1 rats were murdered after 21 days (day 42), whereas group 2 rats entered a third 21-day post-retention period and then murdered (day 63). BW and OTM were measured on days 1, 21, 28, 35, 42, and 63.

RESULTS

Within each group, the animal body weight was reduced significantly after the intervention and continued over time with a higher average reduction in the 9-week group than the 6-week group. However, there were no significant (P-value ˃0.05) differences in the BW between the groups of the two (6-week and 9-week) sets and the subgroups of the 6-week set across each time point. In contrast, there was a significant (P-value ˂0.05) difference between the BW of the conjugate subgroup and the other three subgroups in the 9-week set, particularly on 63^rd day.

CONCLUSION

CaCO₃ nanoparticles and/or BMP with orthodontic treatment collectively or individually cause a reduction of body weight in rats.

Hormone and implant osseointegration: Elaboration of the relationship among function, preclinical, and clinical practice

As clusters of peptides or steroids capable of high-efficiency information transmission, hormones have been substantiated to coordinate metabolism, growth, development, and other physiological processes, especially in bone physiology and repair metabolism. In recent years, the application of hormones for implant osseointegration has become a research hotspot. Herein, we provide a comprehensive overview of the relevant reports on endogenous hormones and their corresponding supplementary preparations to explore the association between hormones and the prognosis of implants. We also discuss the effects and mechanisms of insulin, parathyroid hormone, melatonin, vitamin D, and growth hormone on osseointegration at the molecular and body levels to provide a foothold and guide future research on the systemic conditions that affect the implantation process and expand the relative contraindications of the implant, and the pre-and post-operative precautions. This review shows that systemic hormones can regulate the osseointegration of oral implants through endogenous or exogenous drug-delivery methods.

Use of Micro-CT Imaging to Assess Ventral Mandibular Cortical Thickness and Volume in an Experimental Rodent Model With Chronic High-Phosphorus Intake

Adverse effects of high dietary phosphorus on bone health have been observed in both animal and human studies. The aim of the investigation was to examine chronic effects of high phosphorus diet on the apical mandibular cortical thickness and volume in a hystricomorph rodent (Octodon degus) using microcomputed tomography. Male degus were randomly divided into two groups fed by different mineral contents from the age of 12 weeks till the age of 17 months. The micro-CT scanning and wall thickness analysis were applied on the region of the mandible exactly under the apices of the 4th premolar tooth, first molar tooth, and second molar tooth in two animals from each group. General overview and mapping of the ventral mandibular bone thickness revealed pronounced bony mandibular protrusions in all the animals fed a high-phosphorus diet with obvious bone thinning apically to the 4th premolar and first and second molar tooth apices. Mandibular bone volume and thickness located apically to the premolar and molars were statistically significantly smaller/thinner in the group fed by a high phosphorus diet. The thinnest bone measured 0.004 mm, where the mandibular 4th premolar tooth almost perforated the mandibular cortex. Similar studies of metabolic bone disease and its influence on alveolar bone were also published in rats and mice. The influence of different environmental, infectious, or metabolic factors on the growing tooth, alveolar bone formation, and bone pathologies must be done experimentally on growing animals. In contrast, degus have continuously growing dentition, and the effect of any of the above listed factors can be studied in this animal model at any age and for longer time periods.

Influence of Intermittent Parathyroid Hormone (PTH) Administration on the Outcomes of Orthodontic Tooth Movement—A Systematic Review

Objective: The aim of this review is to summarize the effects of local and systemic PTH administration on periodontal tissues during orthodontic tooth movement. Materials and methods: An electronic search was conducted on the following databases: PubMed/MEDLINE, Google Scholar, SCOPUS and Embase. On PubMed/MEDLINE, the Medical Subject Headings (MeSH) keywords used were: “orthodontic tooth movement” OR (“tooth” (All Fields) AND “tooth movement” (All Fields)) OR “tooth movement” (All Fields)) AND (“parathyroid hormone”); all studies included using CONSORT. Results: After elimination of duplicates and articles not meeting our inclusion criteria, seven animal studies were included in this review. Although the majority of the studies suggest that PTH may a have a favorable outcome on OTM, most studies were found to have several sources of bias. Conclusion: Animal studies with minimal bias and long-term clinical studies are needed to ascertain the efficacy of intermittent PTH administration in improving the rate and retention of OTM.

Effect of ovariectomy-induced osteoporosis on the amount of orthodontic tooth movement: a systematic review of animal studies

BACKGROUND

Understanding the impact of osteopenia and osteoporosis on orthodontic tooth movement could be of benefit to the orthodontist, but research in humans presents practical and ethical problems. The ovariectomized animal model could provide useful information on osteoporosis.

OBJECTIVE

To compare the amount of tooth movement during or after the application of orthodontic forces between ovariectomized animals and control or sham-operated subjects.

SEARCH METHODS

Unrestricted searches in seven databases and manual searching of the reference lists in relevant studies were performed up to February 2021 (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 studies quantitatively comparing the amount of tooth movement during or after the application of orthodontic forces between ovariectomized animals and control or sham-operated subjects.

DATA COLLECTION AND ANALYSIS

Following study retrieval and selection, relevant data were 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

Thirteen studies were finally selected and no specific concerns regarding bias were identified. During the active period, ovariectomy was associated with a statistically significant acceleratory effect on the rate of orthodontic tooth movement compared to non-treated rats (3 weeks; 4 studies, 0.15 mm more movement in the ovariectomized rats; 95 per cent confidence interval: 0.10-0.19; P = 0.000). Exploratory meta-regression showed that this difference could increase over time. Following force discontinuation, no statistically significant differences were observed [3 weeks; 1 study (median ± SE), Ovariectomy group: 0.30 ± 0.04 mm; Sham operation group: 0.18 ± 0.03; P = 0.1558].

CONCLUSIONS

Ovariectomy-induced osteoporosis may affect the rate of orthodontic tooth movement. Although animal studies should be approached with caution regarding their translational potential, the safe practice would suggest that one should consider potential implications.

REGISTRATION

PROSPERO (CRD42018118003).

Effect of pharmacological agents on relapse following orthodontic tooth movement

OBJECTIVES

To investigate and synthesize systematically the evidence from animal studies pertaining to the effect of pharmacological agents on tooth movement relapse following cessation of orthodontic force application.

MATERIALS AND METHODS

An electronic search was conducted in seven online databases (including gray sources) without restrictions until the third week of April 2019, followed by a hand search in the reference lists of eligible articles. Controlled animal studies investigating the effect of pharmacological agents on tooth movement relapse following orthodontic treatment were selected. Relevant data were extracted from eligible studies and the risk of bias assessment was done using SYRCLE's risk of bias tool. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool.

RESULTS

The search identified 2354 records, of which 7 studies were deemed eligible for inclusion in the qualitative synthesis, with the majority presenting an unclear risk of bias. Orthodontic relapse was shown to decrease with the administration of pamidronate disodium, atorvastatin, aspirin, and chemically modified tetracycline-3. Inconsistent effects on relapse were observed after the use of simvastatin. The overall quality of retrieved evidence was assessed as low at best.

CONCLUSIONS

The available evidence shows that the investigated pharmacological agents may demonstrate variable effects on tooth movement relapse following cessation of orthodontic force. Additional evidence of higher quality is required to draw definitive conclusions on their effects and to make potential recommendations for clinical application.

Oral manifestations of magnesium and vitamin D inadequacy

Adequate nutrition is essential for maintaining good oral health. Minerals such as magnesium, calcium, and phosphorus found in the diet constitute the main structural components of the tooth. Their inadequacy leads to absorption impairment, increased bleeding tendency, bone resorption, looseness, and premature tooth loss. Inadequacy of those essential minerals is associated with delayed tooth eruption and with enamel or dentin hypoplasia. Taking calcium without magnesium results in soft dental enamel, which cannot resist the acids causing tooth decay. In addition to magnesium, calcium, and phosphorus, adequate vitamin D is needed to maintain optimal oral health. Vitamin D exerts anti-inflammatory effects and helps in calcium absorption and bone remodeling. Moreover, adequate vitamin D status could reduce formation of dental caries by delaying its onset and progression. Here we summarize the oral manifestations of vitamin D and magnesium inadequacy.