Evaluation of the effect of local administration of PRP vs vitamin D3 on the rate of orthodontic tooth movement and the associated external apical root resorption.

Background: Increased orthodontic treatment duration is associated with iatrogenic risks such as root resorption, white spot lesions etc. Recent research using pharmacological agents to accelerate tooth movement has mostly been conducted on animals and there is no reported research conducted on humans comparing the effects of Vitamin D3 and Platelet Rich Plasma (PRP) in the same subjects using a split mouth technique. Objectives: To determine and compare effects of local injection of PRP and Vitamin D3 on the rate of tooth movement. Also, to assess association of external apical root resorption with the use of PRP, Vitamin D3 and compare it to a control group. Materials & methods: 11 subjects who diagnosed with Class I bi-maxillary malocclusion and who gave informed consent were recruited in the study. The patients were randomly divided using split mouth design and each quadrant served as either experimental or control group one. At the beginning of retraction phase, Vitamin D3 and PRP were injected to the randomly assigned quadrants while the contralateral side served as a control. The amount of space closure in 4 months was measured from distal surface of canine to mesial surface of 2nd premolar. Root resorption was assessed using CBCT taken at the beginning and at the closure of retraction phase. Results: Mean rate of tooth movement was higher in PRP and Vitamin D3 groups compared to their controls. In the PRP group, the increased rate of tooth movement was observed throughout the study interval, but in the Vitamin D3 group it was only seen in first two months. Also, the PRP group demonstrated a higher rate of tooth movement compared to Vitamin D3 group. Root resorption was lesser in both experimental groups. Among the teeth assessed, lateral incisor showed maximum root resorption and canine the least. Conclusions: PRP is a more efficient pharmacological agent compared to Vitamin D3 for accelerating tooth movement.

Effect of fluoride agents on surface characteristics of NiTi wires. An ex vivo investigation.

AIM: To analyze the degree of corrosion of nickel titanium arch wires in patients with and without exposure to fluorides. MATERIAL AND METHODS: This was an ex vivo study comprising of 60 subjects undergoing fixed orthodontic treatment. Group 1(controls) comprised of 30 sets of new unused NiTi wires and unused 11, 15 brackets, Group 2(patients) comprised of 30 sets of non fluoridated NiTi wires and 11, 15 brackets and Group 3(patients) had 30 sets of fluoridated NiTi wires and 11, 15 brackets. NiTi wires were used over 6 months of treatment(0.014″,0.016″, 16 × 22", each wire was used for 2 months and replaced with the next size). All wires were retrieved, stored and analyzed. At 6 months, brackets from 11 to 15 were debonded in both treatment groups. Archwires and brackets in 3 groups were subjected to SEM analysis at 500 and 1000X to observe differences. Additionally, EDX Spectroscopy was undertaken to evaluate surface elemental compositional differences in groups. RESULTS: Significant differences among groups were evident in brackets and archwires tested. Maximum degradation, cracks and dark spots were seen in wires and brackets exposed to fluoride agents. EDX spectroscopy revealed least Ni% in fluoridated wires and brackets. CONCLUSIONS: Increased leaching of metal ions was evident when wires and brackets are exposed to fluoride agents during treatment. Use of non fluoridated mouthwash and toothpastes may be considered in orthodontic patients without risk of caries to mitigate such effects.