Morphological changes in the rat periodontal ligament and its vascularity after experimental tooth movement using superelastic forces.

The aim of this study was to statistically assess the morphological changes of the rat periodontal ligament (PDL) and its vascularity in relation to varied magnitudes of superelastic force in experimental tooth movement using nickel-titanium (NiTi) alloy wire. Forces of 0.8, 1.6, 4, 8, and 18 g were applied to the upper first molars of five groups of 10-week-old male Wistar rats (300-320 g) for 1, 7, 14, 21, and 28 days. A control group with no orthodontic appliance application was assessed in accordance with the five experimental periods. The specimens were observed under light microscopy, processed by computer imaging, and analysed statistically with Tukey's HSD non-parametric test. One day after the start of the experiment, a few blood vessels could be seen in the compressed PDL with forces of 0.8 and 1.6 g. The cross-sectional areas of blood vessels (CAV) and periodontal ligament (CAPL) in the experimental groups where a force of over 4 g was applied were significantly smaller than those where 0.8 and 1.6 g forces were used, and in the control group. On day 7, large CAV were seen in the 1.6, 4, and 8 g groups. On day 28, the 8 and 18 g groups showed significantly larger CAPL than the 0.8, 4 g, or control groups. The findings suggest that a light continuous force, under 1.6 g, maintains the vascular structure during experimental tooth movement. In contrast, a heavy continuous force over 4 g causes the vascular structure to be absent in the early stages of tooth movement, but a dynamic regeneration of the PDL with vascularity and expansion follows.

A new idea and method of tooth movement using a ratchet bracket.

Since ideally effective tooth movement in orthodontics should occur without causing damage to the periodontal ligament (PDL), a new bracket with a ratchet-locking system, the 'Ratchet Bracket', was designed to produce tooth movement while maintaining blood circulation. To define the mechanism of the appliance, a histological study was carried out on four Beagle dogs (9 months old) and a clinical study on five female patients (11 years to 38 years 10 months of age). Five upper canines in the dogs were moved 1.82 mm per month. On light microscopic observations, vascular forms showed a round-oval shape, without undermining bone resorption. No root resorption was observed in the compressed PDL at days 1, 14, and 35 of the experimental period. On fluorescent images at day 46, distinctive bone formation was apparent at the tension side. In the clinical investigation, nine upper canines in the five female patients were moved 1.92 mm per month. A wide and long alveolar hard line was seen only on the tension side of the canines on dental radiographs, indicating bodily tooth movement, without obvious signs of root resorption in all subjects. Neither spontaneous pain nor pain during biting were reported. The findings indicate that use of the ratchet bracket could result in rapid and pain-free tooth movement with vascular clarity to maintain blood circulation in the PDL.