The biological basis of treating jaw discrepancies: An interplay of mechanical forces and skeletal configuration

Abstract

Jaw discrepancies and malrelations affect a large proportion of the general population and their treatment is of utmost significance for individuals' health and quality of life. The aim of their therapy is the modification of aberrant jaw development mainly by targeting the growth potential of the mandibular condyle through its cartilage, and the architectural shape of alveolar bone through a suture type of structure, the periodontal ligament. This targeted treatment is achieved via external mechanical force application by using a wide variety of intraoral and extraoral appliances. Condylar cartilage and sutures exhibit a remarkable plasticity due to the mechano-responsiveness of the chondrocytes and the multipotent mesenchymal cells of the sutures. The tissues respond biologically and adapt to mechanical force application by a variety of signaling pathways and a final interplay between the proliferative activity and the differentiation status of the cells involved. These targeted therapeutic functional alterations within temporo-mandibular joint ultimately result in the enhancement or restriction of mandibular growth, while within the periodontal ligament lead to bone remodeling and change of its architectural structure. Depending on the form of the malrelation presented, the above treatment approaches, in conjunction or separately, lead to the total correction of jaw discrepancies and the achievement of facial harmony and function. Overall, the treatment of craniofacial and jaw anomalies can be seen as an interplay of mechanical forces and adaptations occurring within temporo-mandibular joint and alveolar bone. The aim of the present review is to present up-to-date knowledge on the mechano-biology behind jaw growth modification and alveolar bone remodeling. Furthermore, future molecular targeted therapeutic strategies are discussed aiming at the improvement of mechanically-driven chondrogenesis and osteogenesis.

Bone remodeling induced by mechanical forces is regulated by miRNAs

“…Low intensity vibration (LIV) can increase bone density and can be used in the treatment of osteoporosis and fracture [ 116–117 ]. Moreover, mechanical loading is widely used to treat craniofacial deformities such as jaw discrepancies and cranial suture [ 118 ]. The above findings imply that modulating the expression levels of miRNAs could enhance the efficacy of mechanical force in the treatment of bone diseases…”

Uso de los métodos de diagnóstico de relación esquelética en los artículos publicados del 2018 al 2020 en las cuatro revistas más importantes de ortodoncia

“…También se realizaron estudios para medir la discrepancia esqueletal con el ángulo beta 33 , en los que se le comparó con los valores para caucásicos y se correlacionaron con ANB y Wits. Se concluyó que el ángulo beta es altamente confiable para evaluar las discrepancias sagitales de maxilar y mandíbula, ya que la media y desviación estándar para cada clase esqueletal son estadísticamente diferentes entre ellas.…”