Dental, skeletal and soft tissue changes after bimaxillary protrusion treatment with temporary anchorage devices using different retraction mechanics.

BACKGROUND: Temporary anchorage devices (TADs), which are absolute anchorage, are used for retraction of the anterior teeth in cases of severe bimaxillary protrusion. There have been a number of studies regarding anterior tooth movement using TADs performed by simulation systems and actual treated materials with sliding mechanics. However, there are few studies regarding anterior tooth movement using TADs treated by loop mechanics The purpose of this study was to investigate the effect of TADs in anterior tooth movement using loop mechanics performed in actual cases of bimaxillary protrusion. METHODS: This study was performed in 20 adult patients with severe bimaxillary protrusion treated with four bicuspid extraction with sliding or loop mechanics (n = 10 in each mechanics) using TADs. The skeletal and denture patterns, as well as the soft tissue profile from pre-treatment (T0) and post-treatment (T1) lateral cephalograms, were compared between sliding and closing loop mechanics. RESULTS: The use of TADs is useful for retraction of anterior teeth without molar anchorage loss. in sliding and loop mechanics. The upper anterior teeth were less lingual tipped and lower anterior teeth were more upright resulting in less clockwise rotation of the occlusal plane in loop mechanics compared to sliding mechanics. CONCLUSION: An oblique retraction force vector with a lower point of application causes less intrusion and more lingual tipping of upper anterior teeth as well as more clockwise rotation of the occlusal plane compared to a parallel retraction force vector.

Changes in surface properties of dental alloys with atmospheric plasma irradiation.

Chemical transitions after atmospheric pressure plasma irradiation were investigated by evaluating intermolecular attractions and atomic and molecular reactions. Gold, titanium and stainless-steel alloy samples were ground with #800 grit SiC waterproof paper and nitrogen gas atmospheric plasma irradiation was conducted. The surface free energies of the treated alloys were calculated and compared statistically. X-ray photoelectron spectroscopy analysis was performed.The surface free energies of all metal surfaces treated by plasma irradiation were 1.5-times higher than those of the untreated metals. The energy of the hydrogen bonding component increased, and all alloy surfaces were coated with metal oxide after only a short period of plasma irradiation. The surfaces oxidized by plasma exhibited a high active energy, mainly due to an increase in the hydrogen bonding component. Reactions with oxygen in the air were promoted on the clean surfaces with exposed reactive elements.

Continuous Compressive Force Induces Differentiation of Osteoclasts with High Levels of Inorganic Dissolution.

BACKGROUND Osteoclast precursor cells are constitutively differentiated into mature osteoclasts on bone tissues. We previously reported that the continuous stimulation of RAW264.7 precursor cells with compressive force induces the formation of multinucleated giant cells via receptor activator of nuclear factor kappaB (RANK)-RANK ligand (RANKL) signaling. Here, we examined the bone resorptive function of multinucleated osteoclasts induced by continuous compressive force. MATERIAL AND METHODS Cells were continuously stimulated with 0.3, 0.6, and 1.1 g/cm² compressive force created by increasing the amount of the culture solution in the presence of RANKL. Actin ring organization was evaluated by fluorescence microscopy. mRNA expression of genes encoding osteoclastic bone resorption-related enzymes was examined by quantitative real-time reverse transcription-polymerase chain reaction. Mineral resorption was evaluated using calcium phosphate-coated plates. RESULTS Multinucleated osteoclast-like cells with actin rings were observed for all three magnitudes of compressive force, and the area of actin rings increased as a function of the applied force. Carbonic anhydrase II expression as well as calcium elution from the calcium phosphate plate was markedly higher after stimulation with 0.6 and 1.1 g/cm² force than 0.3 g/cm². Matrix metalloproteinase-9 expression decreased and cathepsin K expression increased slightly by the continuous application of compressive force. CONCLUSIONS Our study demonstrated that multinucleated osteoclast-like cells induced by the stimulation of RAW264.7 cells with continuous compressive force exhibit high dissolution of the inorganic phase of bone by upregulating carbonic anhydrase II expression and actin ring formation. These findings improve our understanding of the role of mechanical load in bone remodeling.

Effect of mechanical strain-induced PGE2 production on bone nodule formation by rat calvarial progenitor cells.

High-magnitude mechanical strain inhibits bone nodule formation by reducing expression of bone morphogenetic protein-2 (BMP-2), Runt-related transcription factor 2 (Runx2), and muscle segment homeobox 2 (Msx2). Mechanical strain also induces production of proinflammatory factor prostaglandin E2 (PGE2) by osteoblasts. We measured the effect of mechanical strain-induced PGE2 production on bone nodule formation and expression levels of bone formation-related factors. Osteoblast-like cells isolated from fetal rat calvariae were loaded with 18% cyclic tension force (TF) for 48 h in the presence or absence of NS-398, a selective inhibitor of cyclooxygenase-2. To investigate the effect of TF-induced PGE2 on bone formation, bone nodule area on day 21 was measured by von Kossa staining. BMP-2, Runx2, and Msx2 expression levels were examined at 1 day after TF loading. Bone nodule formation was significantly inhibited by TF but was restored to control level by PGE2 inhibition. Furthermore, TF loading-induced reductions in expressions of these factors were restored to control level by PGE2 suppression. These results indicate that PGE2 production induced by high-magnitude mechanical strain inhibits bone nodule formation by reducing expression levels of bone formation-related factors.

Risk factors for failure of orthodontic mini-screws placed in the median palate.

This study investigated the stability of mini-screws placed in the median palate. The study included 25 patients (7 males, 18 females; mean age, 23.4 ± 5.6 years; age range, 15.0-34.5 years) who had mini-screws placed during orthodontic treatment at Nihon University School of Dentistry Dental Hospital. Mini-screws (diameter, 2.0 mm; length, 9.0 mm) were placed in the median palatal region; the first screw was inserted mesiodistally at the distal contact of the maxillary first molar, and the second screw was placed 6-9 mm mesial to the first screw. Immediately after placement, the placement sites were carefully examined with cone-beam computed tomography and a Periotest device. Screw stability was not related to perforation of the nasal cavity, patient age, or patient sex. The success rate was significantly higher in patients with screw-suture distances of 1.5-2.7 mm than in those with distances of 0-1.4 mm. Moreover, mini-screws could be stabilized when palatal cortical bone thickness was ≥1.5 mm. The success rate was significantly higher in the group with insertion depths of ≥4.5 mm. These results indicate that primary stability of mini-screws requires sufficient cortical bone thickness, insertion depth, and screw-suture distance.

Effect of the vertical position of the canine on the frictional/orthodontic force ratio of Ni-Ti archwires during the levelling phase of orthodontic treatment.

This study investigated the effect of the vertical position of the canine on changes in the frictional/orthodontic (F/O) force ratio of nickel-titanium (Ni-Ti) archwires during the initial levelling phase of orthodontic treatment. Frictional and orthodontic forces were measured by using low-friction brackets and Ni-Ti archwires with three different cross-sectional sizes and force types. To simulate canine malocclusion (first premolar extraction case), the upper right canine was displaced gingivally by 1 to 3 mm and the inter-bracket distance between the upper right lateral incisor and second premolar was set at 15 mm or 20 mm. A three-point bending test was performed to measure the orthodontic force of each Ni-Ti archwire. Frictional forces were measured with a universal testing machine and dental arch models by pulling parallel to the end of the archwire at a crosshead speed of 0.5 mm/min. F/O force ratio was calculated and analysed statistically. At a displacement of 3 mm, few archwires had F/O force ratios of less than 1.0, at which orthodontic force overcame frictional force, thus ensuring extrusion of the canine. For effective tooth movement, orthodontists should use Ni-Ti archwires with an F/O force ratio of less than 1.0.

Functional comparison of high and low molecular weight basic fibroblast growth factors.

Acid-electrolyzed functional water (FW) is obtained through the electrolysis of sodium chloride solution. Stimulation of the human fibroblastic cell line HeLa by FW led to the augmented secretion of basic fibroblast growth factor (bFGF). Immunoprecipitation followed by Western blot analysis revealed that both high and low molecular weight isoforms of bFGF were secreted in response to FW treatment. To explore intracellular bFGF localization, a cell fractionation assay was performed. Despite the presence of nuclear localization signals within the N-terminal portion of these proteins, the high molecular weight isoforms (34, 24, 22.5, and 21 kDa) were localized in the cytoplasm. FW stimulation drastically reduced the amount of intracytoplasmically localized isoforms, and the 34-kDa isoform was found to localize in a DNase-sensitive fraction, suggesting a weak nuclear attachment. By contrast, the 24-kDa isoform remained in the nucleus even after FW stimulation. Functional differences between the 34- and 18-kDa isoforms were examined further. Chinese hamster ovary cells were transfected with expression plasmids for each isoform. By treating each transfectant with FW, both isoforms were secreted successfully into the culture supernatants. Stimulation of HeLa cells with these supernatants resulted in the augmented secretion of vascular endothelial growth factor (VEGF). To further confirm the functionality of these isoforms, an in vitro transcription/translation reaction was performed; both of the isoforms induced VEGF secretion from HeLa cells. Taken together, these results indicate that the high molecular weight 34-kDa isoform and low molecular weight 18-kDa mature bFGF isoform have identical roles in VEGF induction.

Experimental tooth movement temporally changes neural excitation and topographical map in rat somatosensory cortex.

During orthodontic treatment, binding teeth, may change the topographically organized representation of teeth in the cerebral cortex. To test the hypothesis that experimental tooth movement (ETM) changes the somatotopy of an individual tooth arrangement in the somatosensory cortex, we examined the spatiotemporal features of cortical excitatory propagation in response to mechanical stimulation of the maxillary incisor or molar using optical imaging in late adolescent rats without or with ETM. The ETM models consisted of 1d, 3d, and 7d ETM in which a closed-coil spring was ligated between the maxillary first molar and incisors. In controls, incisor and molar mechanical stimulation evoked excitation in the rostral and dorsocaudal regions of the primary somatosensory cortex (S1), respectively. In addition, the secondary somatosensory cortex and insular oral region (S2/IOR) were also activated. Incisor stimulation-induced excitatory regions in S1 of 3d and 7d ETM shifted without changing the maximum excitatory area or peak amplitude; the incisor stimulation-responding region moved toward the dorsocaudal region, which responded to molar stimulation in the control. This shift in excitatory region was not observed in 1d ETM. One day after removal of the coil spring that was attached for 6 days, the excitatory region shift in S1 was recovered to the control region. On the other hand, 1d ETM exhibited facilitation of the excitatory area and peak amplitude upon molar stimulation, and the facilitation of excitatory propagation disappeared in 3d and 7d ETM. These results may explain the clinical finding that abnormal sensation temporally occurs during orthodontic treatment.

Treatment of bimaxillary protrusion with temporary anchorage devices.

For treatment of severe bimaxillary protrusion in adults, a condition known to be among the most difficult to manage, both the maxillary and mandibular anterior teeth must be fully retracted using all the extraction space available. This article reports the treatment of an adult with severe high-angle bimaxillary protrusion. To correct the protrusion of the anterior teeth, orthodontic anchor screws (OASs) were used to provide absolute anchorage during anterior retraction. Acceptable occlusion, facial profile, and balance were achieved. OASs appear to be very useful for treatment of severe bimaxillary protrusion in adults.

In vitro evaluation of frictional force of a novel elastic bendable orthodontic wire.

OBJECTIVES: To determine the frictional force (FF) of the novel, elastic, bendable titanium-niobium (Ti-Nb) alloy orthodontic wire in stainless steel (SS) brackets and to compare it with those of titanium-nickel (Ti-Ni) and titanium-molybdenum (Ti-Mo) alloy wires. MATERIALS AND METHODS: Three sizes of Ti-Nb, Ti-Ni, and Ti-Mo alloy wires were ligated with elastic modules to 0.018-inch and 0.022-inch SS brackets. The dynamic FFs between the orthodontic wires and SS brackets were measured at three bracket-wire angles (0°, 5°, and 10°) with an Instron 5567 loading apparatus (Canton, Mass). RESULTS: FFs increased gradually with the angle and wire size. In the 0.018-inch-slot bracket, the dynamic FFs of Ti-Nb and Ti-Ni alloy wires were almost the same, and those of the Ti-Mo alloy wire were significantly greater ( P<0.05). FF values were 1.5-2 times greater in the 0.022-inch-slot bracket than in the 0.018-inch-slot bracket, regardless of alloy wire type, and the Ti-Mo alloy wire showed the greatest FF. Scanning electric microscopic images showed that the surface of the Ti-Mo alloy wire was much rougher than that of the Ti-Ni and Ti-Nb alloy wires. CONCLUSION: These findings demonstrate that the Ti-Nb alloy wire has almost the same frictional resistance as the Ti-Ni alloy wire, although it has a higher elastic modulus.

Cone-beam computed tomographic evaluation of changes in maxillary alveolar bone after orthodontic treatment.

This study examined the relationship of vertical and horizontal changes in the alveolar bone crest with upper incisor movement after orthodontic treatment. Tooth movement was measured on lateral cephalograms. Vertical and horizontal changes in the median alveolar crest and distance from the cementoenamel junction and anterior nasal spine to the alveolar crest were measured with cone-beam computed tomography. The incisal edge moved distally, and the cervical point intruded significantly and moved distally. The median alveolar crest decreased by 3.80 ± 2.05 mm. The distance from the labial cementoenamel increased significantly, by 0.35 ± 0.38 mm. The vertical distance from the anterior nasal spine decreased significantly, and the alveolar crest moved distally. Vertical tooth movement was positively associated with change in the distance from the labial cementoenamel junction and inversely associated with vertical change in the distance from the anterior nasal spine on the labial and palatal sides. Lingual tooth movement was positively and negatively correlated with horizontal changes in the labial and palatal alveolar crest and vertical change in the palatal alveolar crest. The lingual movement of incisors was related to labial bone resorption. Greater lingual and extrusive movement of incisors led to a greater decrease in the alveolar bone crest.

Continuous application of compressive force induces fusion of osteoclast-like RAW264.7 cells via upregulation of RANK and downregulation of LGR4.

AIMS: During orthodontic treatment, facilitating osteoclastic bone resorption in the alveolar bone exposed to the compressive force (CF) is an important factor for tooth movement. The present study investigated the effect of CF stimulation on the differentiation of RAW264.7 cells from precursors to mature osteoclasts. MAIN METHODS: The cells were continuously stimulated with 0.3, 0.6, or 1.1 g/cm2 CF-which was generated by increasing the volume of culture medium in the wells of a 96-well plate-in the presence or absence of receptor activator of nuclear factor κB (RANK) ligand (RANKL) for 4 days. KEY FINDINGS: In the presence of RANKL, the number of tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cells and the mRNA levels of dendritic cell-specific transmembrane protein (DC-STAMP) and osteoclast-stimulatory transmembrane protein (OC-STAMP) were increased by application of 0.6 and 1.1 g/cm2 CF as compared to 0.3 g/cm2 CF. The mRNA level of RANK was upregulated whereas that of leucine-rich repeat-containing G-protein-coupled receptor (LGR)4-another RANKL receptor was downregulated by 0.6 and 1.1 g/cm2 CF as compared to 0.3 g/cm2 CF in the absence of RANKL. The proportion of cells with nuclear translocation of the nuclear translocation of nuclear factor of activated T cells (NFAT)c1 was increased by 0.6 and 1.1 g/cm2 CF in the presence of RANKL. SIGNIFICANCE: Continuous application of CF induced the differentiation of RAW264.7 cells into TRAP-positive multinuclear cells by enhancing the expression of DC- and OC-STAMP and the nuclear translocation of NFATc1. This may result from the CF-induced increase in RANK and decrease in LGR4 expression.

Effect of collagenase concentration on the isolation of small adipocytes from human buccal fat pad.

Dedifferentiated fat (DFAT) cells were isolated from mature adipocytes using the ceiling culture method. Recently, we successfully isolated DFAT cells from adipocytes with a relatively small size (<40 µm). DFAT cells have a higher osteogenic potential than that of medium adipocytes. Therefore, the objective of this study was to determine the optimal concentration of collagenase solution for isolating small adipocytes from human buccal fat pads (BFPs). Four concentrations of collagenase solution (0.01%, 0.02%, 0.1%, and 0.5%) were used, and their effectiveness was assessed by the number of small adipocytes and DFAT cells isolated. The total number of floating adipocytes that dissociated with 0.02% collagenase was 2.5 times of that dissociated with 0.1% collagenase. The number of floating adipocytes with a diameter of ≤29 µm that dissociated with 0.02% collagenase was thrice of those dissociated with 0.1% and 0.5% collagenase. The number of DFAT cells that dissociated with 0.02% collagenase was 1.5 times of that dissociated with 0.1% collagenase. In addition, DFAT cells that dissociated with 0.02% collagenase had a higher osteogenic differentiation potential than those that dissociated with 0.1% collagenase. These results suggest that 0.02% is the optimal collagenase concentration for isolating small adipocytes from BFPs.

Easy Debonding of Ceramic Brackets Bonded with a Light-Cured Orthodontic Adhesive Containing Microcapsules with a CO2 Laser.

OBJECTIVE: An easy debonding method for ceramic brackets using a light-cured Bis-GMA resin containing heat-expandable microcapsules and CO2 laser was investigated. BACKGROUND: Ceramic brackets are used frequently in orthodontic treatment because of their desirable esthetic properties. However, the application of heavy force to ceramic brackets in debonding can fracture the tooth enamel and ceramic brackets, causing tooth pain. MATERIALS AND METHODS: In total, 60 freshly extracted bovine permanent mandibular incisors were divided randomly into 10 groups of 6 specimens each, corresponding to the number of variables tested. Ceramic brackets were bonded to bovine permanent mandibular incisors using an orthodontic bonding agent containing heat-expandable microcapsules at different levels (0-30 wt%) and resin composite paste, and cured by a curing device. The bond strengths were measured before and after CO2 laser irradiation, and the temperature increase in the pulp chamber in fresh human first premolars was also evaluated. RESULTS: With CO2 laser irradiation for 5 sec to the bracket, the bond strength in the 25% microcapsule group decreased significantly, to ∼0.17-fold, compared with that of the no-laser group (p < 0.05). The maximum temperature increase in the pulp chamber was 5.3°C with laser irradiation, which was less than the level that induces pulp damage. CONCLUSIONS: From these results, it seems likely that the combined use of a light-cured orthodontic bonding agent containing microcapsules and a CO2 laser is a simple debonding system for ceramic brackets, with less debonding time and enamel damage.

EMMPRIN Inhibits bFGF-Induced IL-6 Secretion in an Osteoblastic Cell Line, MC3T3-E1.

Background: Electrolytically-generated acid functional water (FW) is obtained by electrolyzing low concentrations of saline. Although it has been widely used in clinical practice with various purposes, the underlying mechanisms of action involved have not been fully elucidated so far. We used the human cervical cancer-derived fibroblastic cell line (HeLa), to examine the cytokine secretion profile following FW treatment in the present study. Results: FW stimulation significantly induced the secretion of basic fibroblast growth factor (bFGF) and extracellular matrix metalloproteinase inducer (EMMPRIN). The effect of both factors on osteoblast-like MC3T3-E1 cells was further examined by stimulating the cells with the conditioned medium of FW-stimulated HeLa cells. However, the conditioned medium failed to induce IL-6 secretion. The MC3T3-E1 cells were further stimulated with recombinant bFGF or EMMPRIN or a combination of both factors. Intriguingly, bFGF-stimulated IL-6 induction was totally inhibited by EMMPRIN. Pretreatment with the specific inhibitor of nuclear factor-kappa B (NF-κB) drastically inhibited IL-6 secretion indicating that bFGF-induced IL-6 expression was dependent on NF-κB activation. The phosphorylation status of NF-κB p65 subunit was further examined. The results indicated that EMMPRIN inhibited bFGF-induced NF-κB p65 phosphorylation. Conclusions: These findings suggest that bFGF can induce IL-6 secretion in MC3T3-E1 cells through NF-κB activation. As EMMPRIN inhibited bFGF-induced IL-6 secretion by reducing the p65 subunit phosphorylation, it might be concluded that bFGF and EMMPRIN crosstalk in their respective signaling pathways.

PYK2 mediates BzATP-induced extracellular matrix proteins synthesis.

Mechanical stimuli such as fluid shear and cyclic tension force induced extracellular adenosine triphosphate (ATP) release in osteoblasts. In particular, cyclic tension force-induced ATP enhances bone formation through P2X7 activation. Proline-rich tyrosine kinase 2 (PYK2) mediate osteoblasts differentiation is induced by mechanical stimuli. Furthermore, activation of PYK2 also was a response to integrin by mechanical stimuli. Extracellular matrix protein (ECMP)s, which are important factors for bone formation are expressed by osteoblasts. However, the effect of the interaction of 2'(3)-Ο-(4-Benzoylbenzoyl) adenosine-5'-triphosphate (BzATP), which is the agonist of the mechanosensitive receptor P2X7, with PYK2 on ECMP production is poorly understood. Thus, our purpose was to investigate the effects of PYK2 on BzATP-induced ECMP production in osteoblasts. BzATP increased phospho-PYK2 protein expression on days 3 and 7 of culture. Furthermore, the PYK2 inhibitor PF431394 inhibited the stimulatory effect of BzATP on the expression of type I collagen, bone sialoprotein and osteocalcin expression. PF431396 did not inhibit the stimulatory effect of BzATP on osteopontin (OPN) mRNA expression. These results suggest that mechanical stimuli activate P2X7 might induce ECMPs expression through PYK2 except in the case of OPN expression. Altogether, mechanical stimuli-induced ECMPs production might be implicated by extracellular ATP secretion or integrin via PYK2 activation.

A preliminary study of effects of low-intensity pulsed ultrasound (LIPUS) irradiation on dentoalveolar ankylosis.

The purpose of this experiment was to investigate whether low-intensity pulsed ultrasound (LIPUS) irradiation can inhibit dentoalveolar ankylosis in transplanted rat teeth. LIPUS irradiation (the pulsed ultrasound signal had a frequency of 3.0 MHz, a spatial average intensity of 30 mW/cm2, and a pulse ratio of 1:4) was performed on the face over the re-planted teeth of rats for 4 weeks. After the rats were euthanized, we measured mobility (Periotest value [PTV]) of the transplanted and control teeth using a Periotest. Finally, we performed histological evaluation to detect ankylosis. PTVs tended to be significantly lower for re-planted teeth than for control teeth. Histological evaluation revealed that the roots of all re-planted teeth were coalescent with alveolar bone. Furthermore, no ankylosis was observed in three-fifths of the re-planted teeth following LIPUS irradiation. These results indicate the potential efficacy of LIPUS to inhibit dentoalveolar ankylosis.

Physiological profiles of cortical responses to mechanical stimulation of the tooth in the rat: An optical imaging study.

The periodontal ligament (PDL) includes several types of nerve endings, such as Aß-, Aδ-, and C-fibers, which play critical roles in detecting the strength and direction of occlusal force. Previous studies have demonstrated that electrical stimulation of the PDL activates the somatosensory and insular cortices. However, the profile of cortical excitation in response to mechanical PDL stimulation mostly remains unknown. To investigate the differences in cortical responses to electrical and mechanical stimulation of the maxillary first molar, we performed optical imaging to determine the responding cortical regions in combination with a pharmacological approach. The molar was mechanically stimulated by pulling in the rostral direction, and electrical stimulation was applied via bipolar electrodes inserted into the mesial PDL. Mechanical stimulation initially excited the primary somatosensory cortex (S1), whereas electrical stimulation evoked an initial response between the secondary somatosensory cortex (S2) and insular oral region (IOR). The characteristic feature responding to mechanical stimulation was the rebound response evoked at the end of mechanical stimulation. A longer mechanical stimulation evoked a larger amplitude of the rebound response. A paired-pulse protocol of mechanical stimulation revealed that the amplitude of the second response was smaller than the first response, in accordance with the shorter interstimulus interval. Systemic application of morphine, a potent blocker of nociception, reduced the amplitude of the maximum excitation, particularly in S2/IOR compared to S1. These results suggest that S1 and S2/IOR are principally excited by mechanical and electrical stimulation, respectively, and that S2/IOR is involved in nociception processing.

Three-dimensional evaluation of the location of the mandibular canal using cone-beam computed tomography for orthodontic anchorage devices.

This study investigated guidelines for placement of monocortical screws in the mandible, particularly the mandibular canal. In this study of 35 patients, we used cone-beam computed tomography to determine the distance from the alveolar crest to the superior border of the mandibular canal (DMC) and the shortest distance from the buccal and lingual cortex to the mandibular canal (attaining distance) in the areas between premolars (premolar area), between the second premolar and first molar (middle area), and between the first and second molars (molar area). The DMC values for these areas were 16.55, 18.94, and 16.58 mm, respectively, and were similar in adults and adolescents. When the attaining distance was 8 mm, the heights on the buccal and lingual sides of the areas were 9 and 16.6 mm, 13.7 and 14.7 mm, and 15.3 and 12 mm, respectively. Risk of proximity to the mandibular canal should be considered at above heights or greater when an orthodontic anchorage device (OAD) 8 mm in length is placed. Careful attention is needed for placements on lingual side in adolescents. By reducing the OAD length to 6 mm, placement safety increases in all areas except the premolar area, especially on the buccal side.

Enhancement of Orthodontic Anchor Screw Stability Under Immediate Loading by Ultraviolet Photofunctionalization Technology.

PURPOSE: Ultraviolet (UV)-mediated photofunctionalization technology is intended to enhance the osseointegration capability of titanium implants. There are concerns about orthodontic anchor screws loosening under immediate loading protocols in adolescent orthodontic treatment. The purpose of this in vivo study was to evaluate the effects of photofunctionalization on the intrabony stability of orthodontic titanium anchor screws and bone-anchor screw contact under immediate loading in growing rats. MATERIALS AND METHODS: Custom-made titanium anchor screws (1.4 mm in diameter and 4.0 mm in length) with or without photofunctionalization pretreatment were placed on the proximal epiphysis of the tibial bone in 6-week-old male Sprague-Dawley rats and were loaded immediately after placement. After 2 weeks of loading, the stability of the anchor screws was evaluated using a Periotest device, and the bone-anchor screw contact ratio (BSC) was assessed by a histomorphometric analysis using field-emission scanning electron microscopy. RESULTS: In the unloaded group, Periotest values (PTVs) were ~25 for UV-untreated screws and 13 for UVtreated screws (P < .01), while in the immediate-loading group, PTVs were 28 for UV-untreated screws and 16 for UV-treated screws (P < .05). Significantly less screw mobility was observed in both UV-treated groups regardless of the loading protocol. The BSC was increased ~1.8 fold for UV-treated screws, compared with UV-untreated screws, regardless of the loading protocol. CONCLUSION: Photofunctionalization enhanced the intrabony stability of orthodontic anchor screws under immediate loading in growing rats by increasing bone-anchor screw contact.