Bone Healing And Feasibility Of Orthodontic Tooth Movement Through Regenerated Alveolar Bone

BackgroundThe practical relationships between orthodontics and periodontology are diverse and complex.Orthodontic forces induce the re-orientation and remodelling of periodontal tissue during tooth movement.The appropriate use of force can elicit the tissue reaction desired.On the other hand,orthodontic forces applied incorrectly can have a destructive effect on those tissues.Alveolar ridge augmentation is among the periodontal treatment procedures undertaken to facilitate achievement of orthodontic treatment goals.MethodsTwenty-four standard alveolar bone defects in six male beagle dogs were treated by GBR using either Bio Oss or?-TCP?experimental?whereas the control defects were left empty.The defects were further grouped into either early?E?or late?L?groups,depending on OTM timing after GBR?i.e.one month or two months respectively?.The rates of OTM was measured intraorally,while the CT scan images were used to assess the bone density,alveolar bone height,the second premolar displacement and tipping tendencyThe concentration of osteoprotegerin?OPG?,Receptor activator of nuclear factor kappa-B ligand?RANKL?,vascular epithelial growth factor?VEGF?and matrix metalloproteinases-2?MMP-2?in gingival crevicular fluid?GCF?were examined by immunoassay.ResultsThe clinical features assessment showed no significant difference between BRMs.However,the OPG concentration registered on 3^rd day was significantly higher for?-TCP than Control group.The VEGF concentration on 7^th day was significantly lower for Bio Oss than Control and?-TCP.The experiment group had significantly higher MMP-2 concentration than Control on the 10^th day.There was significant increase on bone density for the experiment groups compared to control at one month with higher bone height at one and two months post-operatively?P?0.05?.Generally,Bio Oss-E and Bio Oss-L recorded the lowest amount of tooth movement than other models of GBRs assessed.Before OTM the control group registered significantly low bone height compared to Bio Oss and?-TCP groups?P?0.01?.The control group was inferior on bone and bone height compared to Bio Oss and?-TCP.After OTM the second premolar displacement for Bio Oss was statistically significantly lower than control group and the OPG concentration at baseline was significantly higher in the control than the Bio Oss group.The?-TCP group registered statistically higher RANKL concentration than control and Bio Oss groups at the end of orthodontic tooth movement.ConclusionsThe type of BRM had fundamental effects on the pattern of healing makers?OPG,VEGF and MMP-2?concentration in GCF at some-point during healing time.Furthermore,the experimental groups had enhanced bone density one-month post-operative with more bone height gain at one and two months post-operative.The Bio Oss group had favourable radiological features?higher alveolar bone level and bone density with less premolar tipping?but showed slower OTM than control group.The late OTM sub-group had favourable radiological features and showed faster tooth movement than Early OTM in Beta-TCP group.The type of regeneration materials used determined the extent of tooth movement in regenerated alveolar bone defects.Whereas,orthodontic force as well as the type of BRMs affected the RANKL and OPG concentration in GCF.