Influence of risedronate on orthodontic tooth movement in rodents: a systematic review and case report.

INTRODUCTION: Bisphosphonates have an inhibitory impact on osteoclastic activity, reducing bone resorption. However, the influence of risedronate on tooth movement is not well-defined. OBJECTIVE: This systematic review assessed the effect of risedronate intake on orthodontic tooth movement. A case report was also provided. METHODS: Two independent reviewers searched six databases (PubMed, Web of Science, Ovid, Lilacs, Scopus, and Open Grey). The searches were carried out in April/2020, and an update was set in place in June/2023. Therefore, the searches considered a timeline from the databases' inception date until June/2023, with no publication date and/or language restrictions. The clinical question focused on evaluating the orthodontic tooth movement and relapse movement (Outcome) in animals (Population) exposed to risedronate (Exposure), compared to control groups (Comparison). The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were applied, and the protocol was registered in PROSPERO (CRD42020168581). The risk of bias was determined using the Systematic Review Centre for Laboratory Animal Experimentation protocol (SYRCLE). RESULTS: Two studies in rats and one in guinea pigs were included in the systematic review. The studies reported a decrease in orthodontic tooth movement, a reduction in the relapse movement, and a reduced number of positive tartrate-resistant acid phosphatase (TRAP) cells, with a significantly reduced number of bone gaps after the administration of risedronate in rats. A case report illustrated the effects of risedronate administration in one patient. CONCLUSION: Based on the systematic review, risedronate seems to impair orthodontic tooth movement and relapse due to a decrease in bone resorption cells.

Influence of risedronate on orthodontic tooth movement in rodents: a systematic review and case report

ABSTRACT Introduction: Bisphosphonates have an inhibitory impact on osteoclastic activity, reducing bone resorption. However, the influence of risedronate on tooth movement is not well-defined. Objective: This systematic review assessed the effect of risedronate intake on orthodontic tooth movement. A case report was also provided. Methods: Two independent reviewers searched six databases (PubMed, Web of Science, Ovid, Lilacs, Scopus, and Open Grey). The searches were carried out in April/2020, and an update was set in place in June/2023. Therefore, the searches considered a timeline from the databases' inception date until June/2023, with no publication date and/or language restrictions. The clinical question focused on evaluating the orthodontic tooth movement and relapse movement (Outcome) in animals (Population) exposed to risedronate (Exposure), compared to control groups (Comparison). The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were applied, and the protocol was registered in PROSPERO (CRD42020168581). The risk of bias was determined using the Systematic Review Centre for Laboratory Animal Experimentation protocol (SYRCLE). Results: Two studies in rats and one in guinea pigs were included in the systematic review. The studies reported a decrease in orthodontic tooth movement, a reduction in the relapse movement, and a reduced number of positive tartrate-resistant acid phosphatase (TRAP) cells, with a significantly reduced number of bone gaps after the administration of risedronate in rats. A case report illustrated the effects of risedronate administration in one patient. Conclusion: Based on the systematic review, risedronate seems to impair orthodontic tooth movement and relapse due to a decrease in bone resorption cells.

RESUMO Introdução: Os bifosfonatos têm um impacto inibitório na atividade osteoclástica, reduzindo a reabsorção óssea. No entanto, a influência do risedronato no movimento dentário não está bem definida. Objetivo: Esta revisão sistemática avaliou o efeito do uso de risedronato no movimento ortodôntico dos dentes. Um relato de caso também é apresentado. Métodos: Dois revisores independentes pesquisaram seis bases de dados (PubMed, Web of Science, Ovid, Lilacs, Scopus e Open Grey), considerando o período de abril de 2020 até junho de 2023, sem restrições de data e/ou idioma de publicação. A questão clínica focou em avaliar o movimento ortodôntico dos dentes e movimento de recidiva (resultado) em animais (população) expostos ao risedronato (exposição) em comparação com grupos de controle (comparação). Foram aplicadas as Diretrizes Preferenciais para Revisão Sistemática e Metanálise (PRISMA) e um protocolo foi registrado no PROSPERO (CRD42020168581). O risco de viés foi determinado utilizando o protocolo do Centro de Revisão Sistemática para Experimentação em Animais de Laboratório (SYRCLE). Resultados: Dois estudos em ratos e um em porquinhos-da-índia foram incluídos na revisão sistemática. Os estudos relataram uma diminuição no movimento ortodôntico dos dentes, uma redução no movimento de recidiva e um número reduzido de células positivas à fosfatase ácida tartarato-resistente (TRAP) com um número significativamente reduzido de falhas ósseas após a administração de risedronato em ratos. Um relato de caso ilustrou os efeitos da administração de risedronato em uma paciente. Conclusão: Com base na revisão sistemática, o risedronato parece interferir no movimento ortodôntico dos dentes e na recidiva devido a uma diminuição nas células de reabsorção óssea.

Estrogen protects dental roots from orthodontic-induced inflammatory resorption.

OBJECTIVE: Root resorption is a side effect of orthodontic tooth movement (OTM). Despite the recognized role of estrogen on bone, there is little information about their effects on orthodontic-induced inflammatory root resorption (OIIRR). We aimed to investigate if estrogen deficiency affects OIIRR in two mice strains. METHODS: Female Balb/C (Balb) and C57BL6/J (C57) mice were ovariectomized (OVX) and replaced with estradiol (E2). Tooth samples subjected or not to OTM were collected and analyzed by microCT, histomorphometry and qPCR. RESULTS: OVX resulted in decreased root volume (RV/TV) and root mineral density (RMD) in Balb mice without OTM. In contrast, OVX did not modify physiological root structure of C57 mice. OTM and OIIRR were increased after OVX in both mice strains after 30 days. E2 replacement reversed this phenotype in Balb, but not in C57 mice. Due to the significant increase of OIIRR in OVX Balb mice, the expression of key molecules was investigated in periodontium. Accordingly, these mice showed increased expression of receptor activator of nuclear factor kappa-B ligand (RANKL), tumor necrosis factor alpha, matrix metalloproteinases-2 and -13 and decreased osteoprotegerin (OPG) and interleukin-10 expression after OTM. E2 replacement reversed the changes of these markers. CONCLUSION: The lack of estrogen in Balb mice without OTM triggered loss of root structure which was positively correlated to RANKL/OPG ratio. Regardless of mouse strain, the absence of estrogen following OTM induced OIIRR. Mechanisms involve the imbalance of RANKL/OPG system, inflammatory and osteoclastic makers.