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.

Phosphatidylinositol-dependent bond between alkaline phosphatase and collagen fibers in the periodontal ligament of rat molars.

Alkaline phosphatase (ALP) is anchored to the outer leaflet of the lipid bilayer via phosphatidylinositol (PI) and ALP activity has been localized in the plasma membrane of numerous tissues. In the periodontal ligament ALP activity is found in the collagen fibers in addition to the plasma membrane of the osteoblasts and fibroblasts. In this study, we examined the distribution of ALP activity in the periodontal ligament of rat molars and also examined whether the bond between ALP and collagen fibers is dependent on PI by using phosphatidylinositol-specific phospholipase C (PI-PLC). ALP activity was distributed in the periodontal ligament. The activity mirrored the distribution of collagen fibers in the periodontal ligament. Cytochemical analysis also demonstrated that ALP activity was located not only in the plasma membrane of fibroblasts, but also in the collagen fiber bundles and fibrils in the periodontal ligament. After treatment with PI-PLC, the loss of ALP activity in the periodontal ligament was observed histochemically, and the loss of ALP activity in the fibroblasts as well as in the collagen fiber bundles and fibrils was observed cytochemically. These results strongly indicate that the bond between ALP and the collagen fibers is also dependent on PI.

Calcification of degenerating tissues in the periodontal ligament during tooth movement.

OBJECTIVE: Calcification of degenerating tissues in the periodontal ligament (PDL) during tooth movement was investigated longitudinally. MATERIALS AND METHODS: Upper first molars of male Wistar rats were moved lingually for 1, 7 and 21 d, following which unfixed undecalcified sections of the lingual PDL (in the pressure zone) were examined histologically, histochemically (autoradiography and electron probe microanalysis). RESULTS: On d 1 of tooth movement, degenerating tissues, together with some calcified particles, were visible in the pressure zone of the lingual PDL. On d 7, substantial calcified aggregations were seen in the degenerating tissues, predominantly situated between the bone and root. This was confirmed by the 45Ca autoradiography. On d 21 of tooth movement, large calcified aggregations were still clearly evident between the bone and root. CONCLUSIONS: This calcification of the degenerating tissues is a self-defense response of the living body to prevent direct contact between alveolar bone and the tooth root during compression of the PDL, so preventing friction between them and the development of ankylosis.

Compensatory bone formation in young and old rats during tooth movement.

The aim of this study was to investigate compensatory lingual alveolar bone formation during tooth movement in young and old rats, using the vital bone marker tetracycline. Wistar male rats were separated into the following groups: 13-week-old rats without appliances (13C: control, n = 5), 60-week-old rats without appliances (60C: control, n = 5), 13-week-old rats with appliances (13E: experimental, n = 10), and 60-week-old rats with appliances (60E: experimental, n = 10). The upper first molars of the 13E and 60E groups were moved lingually using fixed appliances. On the third day of tooth movement, tetracycline (TC) was intra-peritoneally injected in all animals including the controls. On the 21st day of tooth movement, the animals were killed and unfixed, and undecalcified, 5-microm frozen frontal sections of the rat first molar areas in both control and experimental groups were examined under light and fluorescent microscopes. In the 13C group without tooth movement, tetracycline labelling lines were obvious in the alveolar crest, apical areas, and interradicular septum, indicating vertical alveolar bone growth. However, in the 60C control group, tetracycline labelling was almost undetectable throughout the alveolar bone. Although the lingual alveolar crest was resorbed from the periodontal side after lingual tooth movement, the sharp, bright labelling lines were still present from the crest to the lingual periosteal alveolar bone in the 13E group. In the 60E group the lines appeared in the lingual periosteal alveolar bone containing the crest, indicating considerable new bone formation. The results indicate that compensatory bone formation occurs in the alveolar crest area and, consequently, alveolar bone height is maintained, even in aged rats.