Introduction: Orthodontic anchorage is one of the most challenging aspects of Orthodontics. Preventing undesired movement of teeth could result in safer and less complicated orthodontic treatment. Recently, several reviews have been published about the effects of different molecules on bone physiology and the clinical side effects in Orthodontics. However, the effects of local application of these substances on the rate of orthodontic tooth movement have not been assessed. Objectives: The aim of this research was to analyze the scientific evidence published in the literature about the effects of different molecules on orthodontic anchorage. Methods: The literature was systematically reviewed using PubMed/Medline, Scopus and Cochrane databases from 2000 up to July 31st, 2014. Articles were independently selected by two different researchers based on previously established inclusion and exclusion criteria, with a concordance Kappa index of 0.86. The methodological quality of the reviewed papers was performed.Results: Search strategy identified 270 articles. Twenty-five of them were selected after application of inclusion/exclusion criteria, and only 11 qualified for final analysis. Molecules involved in orthodontic anchorage were divided into three main groups: osteoprotegerin (OPG), bisphosphonates (BPs) and other molecules (OMs). Conclusions: Different drugs are able to alter the bone remodeling cycle, influencing osteoclast function and, therefore, tooth movement. Thus, they could be used in order to provide maximal anchorage while preventing undesired movements. OPG was found the most effective molecule in blocking the action of osteoclasts, thereby reducing undesired movements.
Orthodontic treatments have been described as a risk factor for the development of gingival recessions. This descriptive and cross-sectional study was performed to evaluate the alveolar bone morphotype of the upper and lower anterior of 33 orthodontic treatment of candidate patients. The images were obtained from a high-resolution cone beam computerised tomography. Then, the thickness of the alveolar bone plate of teeth was measured in six levels, recording the presence of dehiscences and fenestrations. A total of 2,334 sites were evaluated. The average thickness of the maxillary alveolar bone at the buccal surface was 0.70, 0.62 and 1.43 mm at the cervical, middle and apical levels, respectively, while in the mandibular teeth it was 0.53, 0.50 and 2.96 mm. At the palatal and lingual surfaces, the bone was thicker than the buccal except at the apical level of the mandible. Most of the examined sites were measured less than 1 mm (n = 1,235, 52.9%), associated with high prevalence of bone dehiscences (57.6%) and fenestrations (33.3%), particularly in skeletal Class III patients. The observed bone morphotype involved a high vulnerability to bone resorption, and the subsequent gingival recession occurrence, face to orthodontic movements.
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