Effective Orthodontic Tooth Movement via an Occlusion-Activated Electromechanical Synergistic Dental Aligner

Abstract

Malocclusion is a prevalent dental health problem plaguing over 56% worldwide. Mechanical orthodontic aligners render directional teeth movement extensively used for malocclusion treatment in the clinic, while mechanical regulation inefficiency prolongs the treatment course and induces adverse complications. As a noninvasive physiotherapy, an appropriate electric field plays a vital role in tissue metabolism engineering. Here, we propose an occlusionactivated electromechanical synergistic dental aligner that converts occlusal energy into a piezo-excited alternating electric field for accelerating orthodontic tooth movement. Within an 18-day intervention, significantly facilitated orthodontic results were obtained from young and aged Sprague−Dawley rats, increasing by 34% and 164% in orthodontic efficiency, respectively. The different efficiencies were attributed to age-distributed periodontal tissue status. Mechanistically, the electromechanical synergistic intervention modulated the microenvironment, enhanced osteoblast and osteoclast activity, promoted alveolar bone metabolism, and ultimately accelerated tooth movement. This work holds excellent potential for personalized and effective treatment for malocclusions, which would vastly reduce the suffering of the long orthodontic course.

Rational Design of Flexible Mechanical Force Sensors for Healthcare and Diagnosis

“…Figure 6 a–d illustrates the working mechanism of piezoelectric force sensors [ 76 , 122 , 125 , 151 , 152 , 163 , 182 , 226 , 227 , 228 , 229 , 230 , 231 , 232 , 233 , 234 , 235 , 236 , 237 , 238 , 239 ] and introduces several representative structural design strategies (e.g., fiber arrays, stacked layers, rigid-soft hybrid structure) of sensor architecture. Specifically, Persano et al utilized high-density arrays of aligned piezoelectric nanofibers (e.g., P(VDF-TrFe)) to develop a piezoelectric force sensor with large area (tens of cm 2 ) ( Figure 6 b) [ 163 ].…”

“…However, it remains challenging to improve the sensors performance from multiple aspects simultaneously and realize the on-demand design of mechanical force sensors for specific application scenarios. As shown in Figure 1 , many applications in healthcare and diagnosis are opened up by developments of flexible mechanical force sensors, including pulse wave [ 110 , 111 , 112 , 113 , 114 , 115 ] and muscle softness detection [ 116 ], ICP and IOP measurement [ 117 , 118 , 119 ], throat and cardiac activity monitoring [ 55 , 120 ], abdomen and pulse diagnoses [ 121 , 122 ], as well as force sensing in orthotics [ 123 , 124 ], orthodontics [ 125 ] and skin-prosthesis interface [ 64 ]. While many excellent reviews of flexible pressure sensors can be found in the literature [ 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 ], they focus mainly on the working mechanisms, material selections and device performances.…”

A narrative review of the effects of vitamin D3 on orthodontic tooth movement: Focus on molecular and cellular mechanisms

“…However, OTM is not just a mechanical process; it also involves an inflammatory response and can cause tooth pain, also known as orthodontic pain (Zainal Ariffin et al., 2011 ). Additionally, OTM can result in changes in dental occlusion, which is the way the upper and lower teeth come together when biting or chewing (Wang et al., 2023 ). Individual responses to OTM differ markedly, with some patients acclimating smoothly to the process, whereas others might endure considerable discomfort or struggle with the adjustments in bite occlusion (Cioffi, 2023 ).…”

The applications of flexible electronics in dental, oral, and craniofacial medicine

“…For fabricating electrodes, adopting Cu/PI organic-inorganic composite can help improve deformability when maintaining essential conductivity 24,25 . It is also necessary to design specific structures (e.g., serpentine) of the electrodes to enable the tensile strength 26 . In order to enhance the adhesion of flexible electronics to facial skin, silk, poly(N-isopropylacrylamide) (PNIPAM), and other materials can be used to modify hydrogels to increase the covalent and non-covalent interactions 21 , while some other flexible electronics used to detect physical and biological signals in the oral cavity are mainly attached to mouth guards by using medical-grade epoxy or pastes [27][28][29] .…”

“…For example, the modified polyaniline (PANI) and PVB with increased porous structures coated on electrodes can enhance their ability to enrich ions, thereby boosting the sensitivity of the sensing process 31 . In addition, improving the electrode patterns or array shapes can also improve the sensitivity 21,26 .…”