The biological background of relapse of orthodontic tooth movement

Structured AbstractObjectivesTo develop a clinical practice guideline (CPG) for orthodontic retention (OR).Materials and MethodsThe CPG was developed according to the AGREE II instrument and EBRO (Dutch methodology for evidence‐based guideline development). Reporting was done according the RIGHT statement. A Task Force developed clinical questions regarding OR. To answer these questions, a systematic literature search in PubMed and EMBASE was performed. Two independent researchers identified and selected studies, assessed risk of bias using Cochrane RoB tool and rated quality of evidence using GRADE. The Task Force formulated considerations and recommendations after discussing the evidence. The concept CPG was sent for commentary to all relevant stakeholders.ResultOne systematic review—with 15 studies—met the inclusion criteria. In case of low evidence and lack of outcome measures, expert‐based considerations were developed. Over four meetings, the Task Force reached consensus on considerations and recommendations, after which the concept CPG was ready for the commentary phase. After processing the comments, the CPG was presented to the Dutch Association of Orthodontists, whereafter authorization followed.LimitationsThe paucity of evidence‐based studies concerning OR and the reporting of measurable patient outcomes.ConclusionThis CPG offers practitioner recommendations for best practice regarding OR, may reduce variation between practices and assists with patient aftercare. A carefully chosen retention procedure for individual patients, combined with clear information and communication between orthodontist, dentist and patient will contribute to long‐term maintenance of orthodontic treatment results.

Section: Discussionsupporting

confidence: 75%

Section: Cq1e Which Type Of Removable Retainer Is Best For Retaininmentioning

confidence: 99%

Development of a clinical practice guideline for orthodontic retention

Wouters

Lamberts

Kuijpers-Jagtman

et al. 2019

“…The underlying biological mechanism for relapse remains unclear . Previous studies have implicated collagen and oxytalan fibril bundles of the transseptal group of fibers as key players in this process .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of BSP expression and apoptosis in the periodontal ligament during orthodontic relapse: a preliminary study

McManus

Utreja

Chen

et al. 2014

“…The discontinuation of orthodontic treatment may bring about perturbations in the mechanical environment resulting in teeth moving away from their final corrected position in an attempt to reach a new equilibrium 1 . These processes are similar to those encountered during active treatment, with osteoclasts redistributing in the direction of relapse and bone formation occurring on the opposite side 13,15,16 . Pharmaceutical and other substances may have an impact on the signalling processes that are associated with bone remodelling pathways associated with orthodontic tooth movement and relapse phenomena 18,19 .…”

Section: Discussionmentioning

confidence: 99%

“…Information from histological and molecular studies has suggested that the removal of orthodontic appliances might elicit immediate changes in the mechanical conditions, which could result in alterations resembling those encountered during active treatment 1 . Under the control of biochemical networks similar to those stimulating orthodontic tooth movement, the osteoclasts redistribute in the direction of relapse, while bone is formed on the opposite side 13‐17 …”

Section: Introductionmentioning

confidence: 99%

Could medications and biologic factors affect post‐orthodontic tooth movement changes? A systematic review of animal studies

Kaklamanos

Makrygiannakis

Athanasiou

2020

Immediately after the removal of orthodontic appliances, the teeth might start to drift away from their corrected position in an attempt to reach a new equilibrium. Medications and biologic factors could potentially modulate these processes. The objective of the present systematic review is to systematically investigate and appraise the quality of the evidence regarding the effect of various medications and biologic factors on the rate of relapse following active tooth movement. Search without restrictions in eight databases and hand searching until April 2020 were conducted. Studies performed on animal models investigating the effects of medication and biologic factors on the rate of relapse following orthodontic tooth movement were considered. Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed. Seventeen studies were finally identified, mostly at either high or unclear risk of bias. Ketorolac did not show any significant effects on relapse, while the administration of tetracycline, atorvastatin, psoralen and raloxifene decreased it. Overall, the same result was observed with bisphosphonates with the exception of low dosage of risedronate, which did not have an effect. Osteoprotegerin and strontium resulted in reduced relapse, but not in the immediate post‐administration period. Inconsistent or conflicting effects were noted after the use of simvastatin and relaxin. The quality of the available evidence was considered at best as low. It can be concluded that specific medications and biologic factors may have an effect on the rate of relapse following tooth movement. The orthodontist should be knowledgeable about the substances potentially affecting retention.