Vaska Vandevska-Radunovic

Periodontal tissue reaction during orthodontic relapse in rat molars

Relapse after orthodontic tooth movement (OTM) is an undesirable outcome that involves a number of factors. This study investigated the remodelling of the alveolar bone and related periodontal structures during orthodontic relapse in rat molars. The maxillary right first molars of 35 Wistar rats were moved mesially by a fixed orthodontic appliance for 10 days and the contralateral molars served as controls. The appliances were removed and six animals killed. The molars were allowed to relapse, and the remaining animals were sacrificed at 1, 3, 5, 7, 14, and 21 days. The jaws were sectioned and stained with haematoxylin and eosin and tartrate-resistant acid phosphatase (TRAP). One day after appliance removal, the molars relapsed to a mean 62.5 per cent of the achieved OTM and then steadily relapsed to 86.1 per cent at 21 days. The number of osteoclasts situated along the alveolar bone of the first molars was highest at the end of active treatment and significantly decreased during the relapse period. In the OTM group, osteoclasts were most numerous in the pressure side of the periodontal ligament (PDL). As the molars relapsed over time, the osteoclast distribution shifted, and after 7 days of relapse, TRAP-positive cells were registered in previous pressure and tension sides of the first molars. After 21 days, these cells were concentrated in the distal parts of the PDL of all three maxillary right molars. These results indicate that orthodontic relapse in the rat model occurs rapidly and remodelling of the alveolar bone and PDL plays a central role in the relapse processes of both actively moved and adjacent teeth.

Neuroendocrine cells in Malassez epithelium and gingiva of the cat

Malassez epithelium has been designated as epithelial cell rests, the biological significance of which is still under debate. This study was designed to analyze Malassez epithelium for the presence of neuroendocrine cells. Gingival tissue was included as a positive control. Using immunohistochemistry, confocal and light microscopy, Malassez epithelium and gingival epithelium from mature cats (n=5) were examined for cells containing the neuropeptides calcitonin gene-related peptide (CGRP), substance P (SP), and vasoactive intestinal peptide (VIP). Both Malassez epithelium and the basal epithelial cell layers in gingival rete pegs regularly displayed cells immunoreactive to CGRP, SP, and VIP. The immunopositive cells were most frequently present in the epithelial cell clusters and strands of Malassez located in the cervical half of the periodontal ligament. Double immunolabeling revealed cellular co-expression of CGRP or SP with VIP, and the neuropeptides were co-localized in the cellular compartments. Labeled cells in both epithelia were occasionally supported by immunoreactive nerve fibers. This study shows that cells immunoreactive to CGRP, SP, and VIP are located within the cat Malassez epithelium. The localization of neuroendocrine cells verifies the diversity of this epithelium and confirms that Malassez epithelium is composed of different cell types, in common with epithelia from other locations. The presence of neuroendocrine cells in Malassez epithelium strongly suggests biological functions of this tissue, and the neuropeptide content may thus indicate endocrine functions of the cells.

Prevalence and severity of vestibular recession in mandibular incisors after orthodontic treatment

OBJECTIVE To assess the prevalence and severity of vestibular gingival recession of mandibular incisors after orthodontic treatment and to evaluate possible contributing factors. MATERIALS AND METHODS From the record pool of patients who completed orthodontic treatment from 1999-2006 at the Department of Orthodontics, University of Oslo, Norway, 588 patients fulfilled the inclusion criteria. Intraoral color slides were used for the evaluation of gingival recessions (based on Miller classification), presence of visible plaque, and gingival inflammation. Cephalometric radiographs were used to assess the sagittal intermaxillary relation, mandibular and intermaxillary angles, and the position of the lower incisors. A control group was drawn from the same pool of 588 patients. All statistical analyses were performed using SPSS. RESULTS The prevalence of gingival recessions after orthodontic treatment was 10.3%. Most (8.6%) were classified as Miller Class I, and 1.7% were classified as Miller Class II. Gingival recession was predominantly found on central incisors. Reduction of the sagittal intermaxillary angle and retroclination of the lower incisors was correlated with the development of a more severe gingival recession. CONCLUSIONS The present study indicates that vestibular gingival recession of mandibular incisors after orthodontic treatment is of minor prevalence and severity. The presence of gingival recession or retroclination of the incisors with mesial basal relations increases the risk of more severe gingival recession.

The effect of low level laser therapy (LLLT) on bone remodelling after median diastema closure: A one year and half follow-up study

Abstract Background and objectives Maintenance of a corrected median diastema after orthodontic treatment often requires permanent retention. This study was performed to evaluate low level laser therapy (LLLT) effect on bone density after diastema closure and to determine whether increased density will prevent diastema relapse. Study design Fourteen patients (22 ± 4.78 years) with median diastema (6.79 ± 2.28 mm) were randomly allocated to a lased and a non-lased group (i = 7). The patients in the lased group were exposed to GaAs (904 nm, 30 mW, 5.4 J/session, 3 times/3 min each/every second day). Standardized periapical radiographs of the maxillary central incisors were taken immediately after diastema closure, and at 15 days, 45 days, 3 months, 6 months and 1.5 years. Bone density and linear distances were measured using Digora software. Results Diastema reopening showed no statistically significant differences between the two groups. Reduction in linear distances was noticed in the lased group. Mean percentage changes in bone density were statistically significant between the groups at 15 days and 6 months. Only the periapical area distal to the right central incisor retained significantly higher bone density after 1.5 years. There was an insignificant negative correlation between the diastema size and bone density in the lased group at all experimental periods. Conclusions LLL induced bone remodelling and prevented reduction in bone density in the lased group. Diastema reopening, although minor, did not seem to be significantly affected by the bone density changes. Further studies on a larger sample are necessary to optimize treatment parameters so LLL can be applied on a routine therapeutic basis.

Expression of bone markers and micro-CT analysis of alveolar bone during orthodontic relapse.

OBJECTIVES To investigate biological changes in alveolar bone occurring during orthodontic relapse. MATERIALS AND METHODS Rat maxillary first molars were moved mesially for 10 days. After orthodontic tooth movement (OTM), appliances were removed, and the molars were allowed to relapse for one, three, five, seven, 14 or 21 days. Changes in 3D morphometric parameters of bone located mesial to the first molars were evaluated by micro-CT. Total RNA was isolated from the same bone site, and real-time RT-PCR was used to measure the expression of bone formation and resorption markers. RESULTS One day after appliance removal, the molars relapsed to a mean 73% of the achieved OTM and then steadily relapsed to 93% at 21 days. Tissue mineral density and per cent bone volume increased over the experimental period. Inversely, there was a decrease in total porosity. Gene expression of OCN, Coll-I and ALP decreased during OTM, whilst as the molars relapsed showed tended to increase. Gene expression of RANKL and TRAP increased during OTM. Changes in mRNA expression of H(+)-ATPase were minor. By 21 days post-appliance removal, the remodelling process in rats appeared to have returned to control levels. CONCLUSIONS Bone tissue reactions on a molecular level are similar during OTM and orthodontic relapse. These findings validate the importance of immediate retention following active OTM.

The influence of low-level laser on orthodontic relapse in rats

SUMMARY OBJECTIVES This study evaluated the effect of low-level laser therapy (LLLT) on the tendency of rat molars to relapse following orthodontic tooth movement (OTM). MATERIAL AND METHODS Maxillary rat molars were moved mesially for 10 days. Animals were randomly assigned to group I (non-irradiated) or II (irradiation with LLLT). Appliances were removed, and the molars allowed to relapse for 1, 3, 5, 7, 14, or 21 days; rats in group II received LLLT according to a protocol. Bone density of periapical alveolar bone was measured using radiographs and Digora software. Dental supporting structures were examined histologically with haematoxylin and eosin and tartrate-resistant acid phosphatase. RESULTS In both groups, first molar relapse was rapid 1 day after the end of active treatment; by 21 days percentage relapse was measured as 86.11 per cent in group I, and 72.22 per cent in group II. Osteoclast number was highest at the end of active OTM, and thereafter successively decreased during the relapse phase in both groups. Decrease in number, and redistribution of osteoclasts occurred more rapidly in the non-irradiated than the LLLT group. Whilst molar relapse was generally less and osteoclast numbers generally higher in group II compared to group I, the differences were not significant. There was no significant difference in bone density between the two groups. CONCLUSIONS These results indicate that LLLT may reduce the relapse tendency, possibly due in part to bone formation in previous tension areas, and to redistribution of osteoclasts following removal of orthodontic force. The role of LLLT in the prevention of orthodontic relapse requires further study.

Anterior tooth alignment: A comparison of orthodontic retention regimens 5 years posttreatment

OBJECTIVE To assess orthodontic treatment outcome at debonding and at 3 and 5 years after orthodontic treatment and to investigate the influence of different retention protocols on anterior tooth alignment. MATERIALS AND METHODS Using the Peer Assessment Rating (PAR) Index, 169 patients (74 boys, 95 girls) were analyzed at four stages: pretreatment (T0), posttreatment (T1), 3 years posttreatment (T3), and 5 years posttreatment (T5). The PAR anterior component scores (ACSs) were compared between groups with different retention protocols. In the maxilla, protocols were removable retainer until T3 (MAX1), removable and fixed retainer until T3 (MAX2), and removable retainer until T3 and fixed retainer until T5 (MAX3). In the mandible, protocols were no retainer (MAND1), fixed 3-3 retainer until T3 (MAND2), and fixed 3-3 retainer until T5 (MAND3). RESULTS Mean weighted improvement in PAR score was 88.3% at T1, 86.4% at T3, and 82.1% at T5. The ACS for the maxilla showed no significant differences between the retention protocols at any time point. In the mandible, the group without retention showed a gradual but not significant deterioration in ACS throughout the posttreatment period. At T5 there was a significant difference in ACS between the group that had the retainer removed at T3 and the group that kept the retainer. CONCLUSION The 5-year treatment outcome, as measured by the PAR Index, was good. Stability of the maxillary anterior alignment 5 years posttreatment did not appear to be influenced by choice of retention protocol. Mandibular anterior alignment was significantly better for the group using a fixed retainer compared with the group where the retainer was removed 3 years posttreatment.

Long-term stability of dentoalveolar and skeletal changes after activator - headgear treatment

The aim of this study was to analyze the long-term stability of combined activator-headgear treatment on skeletal and dental structures in Class II patients. The material comprised 26 subjects, 10 girls and 16 boys. All had a molar Class II relationship, overjet > or =6 mm, and overbite > or =5 mm. They were treated in one practice with combined activator and headgear appliances. Lateral cephalometric radiographs and dental study casts were taken before treatment (T0, mean age 11.9 years), at the end of activator-headgear treatment (T1, mean age 15.9 years), and 12-15 years out of retention (T2, mean age 28.6 years). Nineteen cephalometric and nine dental cast variables were evaluated using a paired sample t-test between T0-T1, T1-T2, and T0-T2. At T1, the majority of the cephalometric measurements showed statistically significant changes. ANB was significantly reduced by 2.3 degrees due to a significant increase in SNB, but only small changes were observed in SNA. The interincisal angle increased as a result of significant retroclination of both maxillary and mandibular incisors. All patients achieved a Class I molar relationship and a significant reduction in overjet and overbite. At T2, the results showed only slight relapse from T1. However, the relapse did not compromise the significant improvement in almost all the cephalometric and dental variables. Combined activator-headgear treatment improved the skeletal and dental conditions and the results remained stable in the long term.

Dynamics of orthodontic root resorption and repair in human premolars: a light microscopy study

The purpose of the study was to investigate the relationship between root resorption and repair in human premolars that had been orthodontically intruded. The objective was to examine these processes related to time and root development. Seventy-six premolars were divided into subgroups: 33 teeth were intruded and then extracted (G1); 25 teeth were intruded and then left in situ for varying periods before extraction (G2); 18 teeth served as the controls (G3). All teeth were examined by light microscopy. Using non-parametric statistical analysis, differences between the groups were examined with the Pearson chi-square test. Teeth in G1 and G2 had significantly more resorptive lesions, 55 and 64 per cent, respectively, than the controls of 11 per cent. Resorption was observed over the whole root surface and increased with time. The occurrence increased to 100 per cent in both experimental groups after 36 days of intrusion. The appearance of lesions in relation to root development showed no differences between G1 and G2. In the apical part of the root, total resorption of the dentine was sometimes observed, but no resorptions extended into the predentine. Resorptive lesions undergoing repair were seen in both groups, with significantly more repair in G2 (58 per cent) than in G1 (32 per cent). Active resorption and repair were sometimes seen at the same resorption site. Deposition of cellular and acellular cementum was found to the same extent over the whole root when repair took place. With time, resorption appeared over the whole root surface. In some teeth, resorptive activity continued up to 10 days after removal of forces but on the other hand, repair of the resorbed area sometimes started during active movement. The individual variation in repair was much wider compared with resorption. The predentine layer in the apical area appeared not to be affected by the resorptive process.

A histomorphometric and radiographic study of replanted human premolars

SUMMARY OBJECTIVES The purpose of this study was to investigate time-related dental tissue reactions to tooth replantation in mature and immature human premolars by histomorphometric and radiographic methods. MATERIAL AND METHODS Sixty premolars were extracted, immediately replanted (T0), and left without intervention for 1, 2, 3, 6, 12, and 24 weeks before re-extraction (T1). Periapical radiographs were taken at T0 and T1 in all groups except for the 24 week group. Paraffin-embedded teeth were sectioned buccolingually at 5 µm, stained with haematoxylin-eosin, and prepared for histological analysis. Root resorption, tertiary dentine, and root and crown length were recorded and compared on both radiographs and paraffin sections. RESULTS Initial degeneration of the odontoblast layer and disturbance of vasculature and normal architecture of the pulp were seen in both mature and immature teeth within the first 3 weeks. Revascularization and tertiary dentine formation was visible on histological sections in immature teeth at 6 weeks. After 24 weeks, most immature teeth had pulps partly or completely obliterated. Abundant tertiary dentine observed on histological slides was not easily seen on periapical radiographs. Likewise, surface root resorption found in both immature and mature teeth was not visible on the radiographs up to 6 weeks after replantation. CONCLUSION Within the limits of this study it can be concluded that the dental pulp of immature teeth has the ability to regenerate and produce tertiary dentine after replantation. Root resorptions and tertiary dentine seen on histological sections are not visible on corresponding radiographs 6 and 12 weeks after replantation.