Comparing two different Vibration frequencies on the rate of orthodontic Tooth Movement

Recruiting

• Conditions: Disturbances in tooth eruption,

• Registration Number: CTRI/2021/01/030823
• Lead Sponsor: Dr Sakshi Sachdeva

Brief Summary

As professionals, orthodontists aim to deliver a quality outcome for their patients. Not surprisingly, there is a demand by the public for shorter treatment times. Traditionally, orthodontic treatment involves 2 or more years in fixed appliances but with the advent of new technology and researches it has been reported to shorten to less than 2 years . This has been done to cater to the demands of the patients in these changing times for which various surgical and non-surgical treatment options have been opted for by the orthodontists. In order to enhance the orthodontic tooth movement, even mechanical vibrations have been used but, the paucity of clinical research evaluating their efficacy is of low quality . It has been widely known that treatment involving premolar extractions take a much longer time period as compared to the non-extraction cases . In such cases if it were possible to accelerate tooth movement to shorten the treatment time with a non-invasive procedure, this would result in a desirable outcome. Treatment time depends on the rate of tooth movement, which in turn depends on the rate of alveolar re- modeling .

Therefore, it may be possible to increase the rate of tooth movement by accelerating the biologic response of PDL and alveolar bone . Although the exact mechanism of alveolar remodeling is not completely understood, there are 2 main hypotheses: (a) piezoelectricity generated within the alveolar bone, and (b) pressure-tension within the periodontal ligament.

Periodontal ligament cells play a major role in initiation of the remodeling process during orthodontic tooth movement . Compression of PDL is a prerequisite for tooth movement. The balance between *RANKL* and *OPG* in PDL cells regulates bone remodeling during tooth movement . Compressive force up regulates *RANKL* via a PGE2-dependent mechanism in PDL cells . PGE2 is anti -inflammatory mediator produced by PDL cells in response to mechanical stress that acts in autocrine and paracrine manners to stimulate *RANKL* expression and promote bone resorption . In addition, the direct action of prostaglandins on an increasing of osteoclast function and bone resorption has been reported .

Orthodontic tooth movement also causes root resorption . Studies have shown that these side effects are related mainly to the treatment time, so acceleration of orthodontic tooth movement thus shortening the treatment time. Vibration, being a completely non-invasive procedure has gained a lot of attention in is an effective solution the recent years although not well used. Currently, the optimal frequency and intensity of the vibration load are not well studied but it is believed that they are related to the tooth- periodontal ligament bone complex. The optimal frequency may be related to the natural frequency of the tooth –periodontal ligament bone complex .

Through this study, the principal investigator would like to compare 2 different frequencies and determine that frequency which helps in accelerating the orthodontic treatment. Doing a molecular analysis and checking the RANKL/OPG ratios will confirm the same.

Detailed Description

Not available

Study Timeline

• Study Start: 2021-02-02
• Last Update Posted: 2021-12-24

Recruitment & Eligibility

• Status: Open to Recruitment
• Sex: All
• Target Recruitment: 28

Inclusion Criteria

• 1. Subjects must be 18.
• 45 years of age 2. Subjects that require bilateral 1st premolar extraction. 3. Subjects must have complete adult dentition (excluding third molars) 4. Subjects must have class I malocclusion or mild class II/III malocclusions.

Exclusion Criteria

• Subjects who are taking medication that could affect the level of inflammation, such as chronic antibiotics, phenytoin, cyclosporine, ant-inflammatory drugs, systemic corticosteroids, or calcium channel blockers.
• Subjects missing adult teeth (except the 3rd molars) or with severe class II or class III malocclusion.
• Subjects with skeletal class I but extreme dental malocclusion 4.
• Severe crowding that require extraction 5.
• Subjects having systemic diseases effecting bone metabolism 6.
• Subjects who are non-compliant regarding the recommended daily usage of the device.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To compare the efficacy of 2 different frequency vibrations in accelerating tooth movement.	T0- Before the start of retraction | T1- After 2 months of using 1 frequency | 1 Month washout period | T2- After 2 months of using second frequency
To measure the total amount of retraction in each of the frequencies by measuring distance from distal	T0- Before the start of retraction | T1- After 2 months of using 1 frequency | 1 Month washout period | T2- After 2 months of using second frequency
of the canine to the third rugae.	T0- Before the start of retraction | T1- After 2 months of using 1 frequency | 1 Month washout period | T2- After 2 months of using second frequency

Secondary Outcome Measures

Name	Time	Method
To collect the GCF samples and compare the RANKL/OPG ratio for different frequencies in the	patients

Trial Locations

Locations (1)

Manipal College of Dental Sciences, Mangalore; 🇮🇳 Kannada, KARNATAKA, India

Manipal College of Dental Sciences, Mangalore

🇮🇳Kannada, KARNATAKA, India

Sakshi Sachdeva

Principal investigator

8197030435

sakshisachdeva56@gmail.com