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PubMed1975

[Quantitative study on the effects of parathyroidectomy on the osseous remodelling and physiological migration of teeth in the rat].

Numerous hypotheses have been advanced to explain the factors determining the rhythm and direction of the physiological drift of the teeth, but the exact causes of the phenomena are still poorly understood. Since dental mesial drift and alveolar bone remodeling are closely associated, the influence of the parathyroid hormone, systemic factor of bone remodeling, was studied. A cessation of physiological mesial drift was observed in 8 days on parathyroidectomized rats without the use of any direct local action or compression of the periodontal ligament, on the resorbing alveolar side. Parathyroid hormone injection in rats parathyroidectomized for 4 days allowed the development of physiological drift in the same direction. Alveolar bone is therefore parathyroid hormone dependent : the remodeling seemed to determine the physiological drift whereas a local factor seemed to determine the direction.

Alveolar Process↗
PubMed2006

A review of the shortened dental arch concept focusing on the work by the Käyser/Nijmegen group.

The aims of this paper were to review the literature on shortened dental arches with special focus on publications of the Käyser/Nijmegen group, and to evaluate the discussions on the shortened dental arch concept found in the literature. A MEDLINE (PubMed) search was conducted for articles in English published in the dental literature from 1966 to November 2005. The search revealed epidemiological, cross-sectional and longitudinal clinical studies as well as opinion papers, the majority of which were published by the Dutch group. The studies found in general no clinically significant differences between subjects with shortened dental arches of three to five occlusal units and complete dental arches regarding variables such as masticatory ability, signs and symptoms of temporomandibular disorders, migration of remaining teeth, periodontal support, and oral comfort. The findings from cross-sectional studies were corroborated longitudinally. No systematic clinical study with conflicting results was found. The shortened dental arch concept was accepted by a great majority of dentists but not widely practised. The studies reviewed showed that shortened dental arches comprising anterior and premolar teeth in general fulfil the requirements of a functional dentition. It may therefore be concluded that the concept deserves serious consideration in treatment planning for partially edentulous patients. However, with ongoing changes, e.g. in dental health and economy, the concept requires continuing research, evaluation and discussion. Patients' needs and demands vary much and should be individually assessed but the shortened dental arch concept deserves to be included in all treatment planning for partially edentulous patients.

Attitude of Health Personnel↗
PubMed2004

Retention procedures for stabilising tooth position after treatment with orthodontic braces.

BACKGROUND: Retention is the phase of orthodontic treatment that attempts to keep teeth in the corrected positions after orthodontic (dental) braces. Without a phase of retention there is a tendency for the teeth to return to their initial position (relapse). To prevent relapse almost every patient who has orthodontic treatment will require some type of retention. OBJECTIVES: To evaluate the effectiveness of different retention strategies used to stabilise tooth position after orthodontic braces. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Several journals were handsearched. No language restrictions were applied. Authors of randomised controlled trials (RCTs) were identified and contacted to identify unpublished trials. Most recent search: December 2002. SELECTION CRITERIA: RCTs on children and adults, who have had retainers fitted or adjunctive procedures undertaken, following orthodontic treatment with braces to prevent relapse. The outcomes are: how well the teeth are stabilised, survival of retainers, adverse effects on oral health and quality of life. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two reviewers. As no two studies compared the same retention strategies (interventions) it was not possible to combine the results of any studies. MAIN RESULTS: Four trials satisfied the inclusion criteria. These trials all compared different interventions: circumferential supracrestal fiberotomy (CSF) combined with full-time removable retainer versus a full-time removable retainer alone; circumferential supracrestal fiberotomy (CSF) combined with a nights-only removable retainer versus a nights-only removable retainer alone; removable Hawley retainer versus a clear overlay retainer; and three types of fixed retainers versus a removable retainer. There was weak unreliable evidence, based on data from one trial, that there was a statistically significant increase in stability in both the mandibular (p < 0.001) and maxillary anterior segments (p < 0.001) when the CSF was used, compared with when it was not used. There was also weak, unreliable evidence that teeth settle quicker with a Hawley retainer than with a clear overlay retainer after 3 months. The quality of the trial reports was generally poor. REVIEWER'S CONCLUSIONS: There are insufficient research data on which to base our clinical practice on retention at present. There is an urgent need for high quality randomised controlled trials in this crucial area of orthodontic practice.

Humans↗
PubMed2006

Retention procedures for stabilising tooth position after treatment with orthodontic braces.

BACKGROUND: Retention is the phase of orthodontic treatment that attempts to keep teeth in the corrected positions after treatment with orthodontic (dental) braces. Without a phase of retention there is a tendency for the teeth to return to their initial position (relapse). To prevent relapse almost every patient who has orthodontic treatment will require some type of retention. OBJECTIVES: To evaluate the effectiveness of different retention strategies used to stabilise tooth position after orthodontic braces. SEARCH STRATEGY: The Cochrane Oral Health Group's (OHG) Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Handsearching of orthodontic journals was undertaken in keeping with the Cochrane OHG search programme. No language restrictions were applied. Authors of randomised controlled trials (RCTs) were identified and contacted to identify unpublished trials. Most recent search: May 2005. SELECTION CRITERIA: RCTs on children and adults, who have had retainers fitted or adjunctive procedures undertaken, following orthodontic treatment with braces to prevent relapse. The outcomes were: how well the teeth were stabilised, survival of retainers, adverse effects on oral health and quality of life. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. As no two studies compared the same retention strategies (interventions) it was not possible to combine the results of any studies. MAIN RESULTS: Five trials satisfied the inclusion criteria. These trials all compared different interventions: circumferential supracrestal fiberotomy (CSF) combined with full-time removable retainer versus a full-time removable retainer alone; CSF combined with a nights-only removable retainer versus a nights-only removable retainer alone; removable Hawley retainer versus a clear overlay retainer; multistrand wire retainer versus a ribbon-reinforced resin bonded retainer; and three types of fixed retainers versus a removable retainer. There was weak unreliable evidence, based on data from one trial, that there was a statistically significant increase in stability in both the mandibular (lower) (P < 0.001) and maxillary (upper) anterior segments (P < 0.001) when the CSF was used, compared with when it was not used. There was also weak, unreliable evidence that teeth settle quicker with a Hawley retainer than with a clear overlay retainer after 3 months. The quality of the trial reports was generally poor. AUTHORS' CONCLUSIONS: There are insufficient research data on which to base our clinical practice on retention at present. There is an urgent need for high quality randomised controlled trials in this crucial area of orthodontic practice.

Humans↗
PubMed1992

Effects of prostaglandin inhibition on the bone activities associated with the spontaneous drift of molar teeth in the rat.

Little is known about local bone regulation that enables spontaneous molar tooth drift. In this study the role of prostaglandins (PGs) were investigated in the rat by inhibiting PG-synthesis with indomethacin (7 mg/kg/d). Untreated animals were killed at the start of the experiment, while treated ones were killed after 3, 7, or 14 days of treatment. Mandibles were processed for histomorphometry without demineralization. Changes in osteoclasts and extent of the different steps of the bone remodeling sequence (resorption, reversal, and formation) were assessed along the remodeling side of the socket of the buccal root of the first molar. The total number of osteoclasts decreased after 7 days of PG inhibition (P < 0.01 vs controls) and then partially recovered. This change was due to a sharp decrease in active cells on day 7 (P < 0.01), while inactive cells remained unchanged throughout the experimental period. The extent of resorption fell on day 7 (P < 0.01) and then recovered almost to the control level on day 14. Reversal at first increased insignificantly and thereafter decreased (P < 0.02) for the remaining 7 days. Formation was modified only on day 14; at that time it had doubled compared with controls. These results show that PGs are involved in the local regulation of bone remodeling accompanying tooth drift. Resorption inhibition was partial, indicating that other factors participate with PGs in this regulation; in addition, the trend to recovery observed at the end of the experimental period suggests that these factors can take over from PGs to achieve the necessary remodeling of the socket.

Alveolar Process↗
PubMed1993

Inhibition of prostanoid synthesis depresses alveolar bone resorption but enhances root resorption in the rat.

Tooth drift requires the deformation of the root socket and the adjustment of the other components of the attachment apparatus, namely, the periodontal ligament (PDL) and the cementum. Indomethacin (7.5 mg/kg/d), an inhibitor of prostanoid synthesis, provoked in rats a depression in the bone resorption effecting the deformation of the socket (Lasfargues and Saffar, Anat. Rec., 234:310-316, 1992). In the present paper we examined the consequence of this treatment both on the PDL and the root surface. After 3 days of treatment, when osteoclastic resorption was not yet disturbed, the root had been markedly resorbed (P < 0.05) opposite the resorbing bone surface; at that time the PDL width remained in the normal range. After 7 days, i.e., when the bone resorption was depressed, the PDL was widened as the result of the ongoing root resorption. Despite the extensive root resorption, the anchorage of the PDL fibers appeared to remain effective, suggesting that it was rapidly restored. On day 14 at the time of the bone resorption recovery, cementum was deposited in the root resorption lacunae and the PDL width had returned to its control value. As early as day 3 the daily rate of dentine formation increased in the pulp area subjacent to the root resorption lacunae (P < 0.01). These data demonstrate that i) the responses of the different components of the periodontal apparatus are coordinated to allow for the maintainance of the PDL width so that when bone resorption is disturbed, root resorption compensates for it, and ii) the odontoclasts can differentiate and resorb under prostanoid inhibition whilst osteoclastic resorption of the bone socket is inhibited.

Adaptation, Physiological↗
PubMed1995

Alveolar bone turnover in male rats: site- and age-specific changes.

BACKGROUND: This study compares alveolar bone turnover adjacent to distally drifting maxillary first molar teeth of rapidly and slowly growing rats. METHODS: Two groups of forty male rats (1 and 3 months) were sacrificed. Sera were analyzed for acid (AcP), alkaline (AlkP), and tartrate-resistant acid phosphatase (TRAP). Bone histomophometry was done on parasagittal sections of maxillary molars. Molar drift was quantified cephalometrically. RESULTS: Distal surface contained more osteoclasts and higher osteoclast percents than mesials at both ages (P < 0.001). There were also more osteoclasts on the distals of the older rats as compared to the young (P < 0.001). Osteoblast percents were higher (P < 0.001) in the older rats on both surfaces. Mesials had higher double-labeled surface, MAR and BFR than distals in the younger rats (P < 0.001). The younger rats had higher (P < 0.001) AlkP, AcP, and TRAP. There were no age-specific differences in rate of molar drift. A model of rate of molar drift (P < 0.0015) containing bone formation measures accounts for 54.9% of the variability. CONCLUSIONS: We conclude that the bone turnover dynamics adjacent to maxillary first molars represent predominantly remodeling on the distal in both groups and modeling on the mesial only in the young rats, that distal molar tooth drift reflects alveolar bone turnover, and that alveolar bone manifests the marked reduction in bone cell activity that occurs in the rat skeleton after 8 weeks but that this reduction is compensated by recruitment or maintenance of more bone cells at these sites.

Aging↗