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Objectives To investigate the susceptibility of partially desalivated rats to erosive tooth wear (ETW); the anti-erosive effect of a calcium-supplemented beverage; and the quantification of ETW by microcomputed tomography (micro-CT). Methods The study population consisted of thirty-eight rats, divided into partially desalivated (n = 19) and normal salivary flow (n = 19). They were randomly allocated into three subgroups (n = 6-7): A-diet soda, B-diet soda + calcium, C-water (control). Solutions were provided ad libitum for 28 days, and the rats were euthanized afterwards. Each left hemi-mandible was scanned using micro-CT for enamel volume (three molars) calculation. Visual analysis of photographs of the lingual surface of first molars was performed independently by three blinded examiners. Data were statistically analysed (α = .05). Results Micro-CT revealed no significant differences between partially desalivated or normal groups. Rats consuming A had more enamel loss than those consuming B or C, which did not differ from each other. For visual analysis, desalivation did not affect ETW. Rats consuming C showed the lowest ETW, followed by B and then A, for both partially desalivated and normal rats. Spearman correlation between the two ETW quantification methods was -.65. Conclusions Partial desalivation did not increase ETW. Ca-containing beverage prevented ETW. Micro-CT quantified ETW, although it was not as sensitive as visual analysis.

Purpose Recent case reports suggest that amnion-chorion membranes (ACM) and dense polytetrafluoroethylene membranes (dPTFE) can be left exposed during ridge preservation. The aim of this study was to compare the effectiveness of these membranes in ridge preservation, particularly when they are intentionally left exposed. Materials and methods A split-mouth, single-blind, randomized trial design was used to compare treatments with the two membranes in 22 nonmolar sites on the same arch. Ridge dimensions were recorded clinically and with cone beam computed tomography prior to and 3 months after ridge preservation. Postoperative discomfort was recorded with Visual Analog Scale (VAS) forms. Mixed‑model analysis of variance was used to test significance. Results Clinical and radiographic ridge dimensions were not significantly different between the two treatments. ACM sites had significantly more osteoid and higher bone volume density but significantly less graft particles and bone surface density compared with dPTFE. Mineralized bone area and soft tissue area were not significantly different between the two treatments. ACM sites had significantly lower postoperative VAS scores compared with dPTFE. Conclusion Intentionally exposed ACM is equally effective in ridge preservation compared with dPTFE. Additionally, ACM use may aid in reducing postoperative VAS scores, and potentially result in better quality of bone available for implant placement, as evidenced by improved histomorphometric measures.

BACKGROUND Growth factors contained in platelet-rich plasma (PRP) have been reported to induce osteoblast differentiation in certain studies, while in others, osteogenesis has not been shown clinically. The aim of the present study was to verify the effect of PRP and its combination with rhBMP-2 as a controlled delivery system during sagittal suture distraction osteogenesis. METHODS Thirty-six-week male New Zealand white rabbits were randomly assigned to sagittal suture distraction osteogenesis groups treated with (1) PRP gel alone; and (2) PRP gel mixed with 10 μg rhBMP-2 (PRP/rhBMP-2), and a control group untreated. A heavy 200-g continuous mechanical force was applied for 33 days using a nickel titanium open spring to distract the suture between 2 miniscrew implants. The suture morphology was evaluated radiographically and histologically after sacrifice. RESULTS The amount of suture separation in the control group and the PRP gel group were statistically greater (P < 0.05) than in the PRP/rhBMP-2 gel group. Compared to the control group, the micro-CT and histologic analysis showed that the local application of PRP gel not only stimulates the new bone formation between the suture gap but accelerates the suture wound healing during distraction without suture fusion. There was a percent of total suture height 15.3 ± 9.5% fusion in PRP/rhBMP-2 gel group and the average thickness of cranium bone in the PRP/rhBMP-2 gel group was statistically greater (P < 0.05) than in the control group and the PRP gel group. CONCLUSIONS In this animal model, both PRP gel and PRP/rhBMP-2 gel are effective in improving new bone formation in suture distraction osteogenesis. PRP gel induces suture bone formation without suture fusion and accelerates the suture wound healing, while the PRP/rhBMP-2 gel group, in which the sutures fused prematurely, showed powerful bone formation ability aided by rhBMP-2. PRP can be alternatively use as a controlled release system for rhBMP-2, but caution should be used before proceeding with the application of high-dose growth factors around the growing craniofacial sutures.

Objective: BoneCeramic can regenerate bone in alveolar defects, but it remains unknown whether it is feasible to move a tooth through BoneCeramic grafting sites. The objective of this study was to investigate three-dimensional real-time bone responses and micromechanical properties in the grafting sites during orthodontic tooth movement. Methods: Sixty 5-week-old rats were randomly assigned into three groups to receive BoneCeramic, natural bovine cancellous bone particles (Bio-Oss), and no graft, respectively, after the extraction of the left maxillary first molar. After 4 weeks, the maxillary left second molar was moved into the extraction for 28 days. Dynamic bone microstructures and root resorption were evaluated using in vivo micro-computed tomography and histology. Stress distribution of tooth roots and biomechanical properties of corresponding bone tissue were examined by finite element methods and nanoindentation. Mixed-model analysis of variance was performed to compare the difference among time points with Bonferroni post hoc tests at the significance level of P < .05. Results: The BoneCeramic group had the least amount of tooth movement and root resorption volume and craters, highest bone volume fraction, trabecular number, mean trabecular thickness, microhardness, and elastic modulus, followed by Bio-Oss and the control group. The highest stress accumulated in the cervical region of the mesial roots. Conclusion: BoneCeramic has better osteoconductive potential and biomechanical properties and induces less root resorption compared with Bio-Oss grafting and naturally recovered extraction site.

Objective: To investigate three-dimensional microarchitecture and micromechanical properties of alveolar bone in the BoneCeramic grafting sites during orthodontic tooth movement. Materials and Methods: Sixty 5-week-old rats were randomly assigned into three groups to receive BoneCeramic, natural bovine cancellous bone particles (Bio-Oss), and no graft, respectively, after the extraction of the left maxillary first molar. After 4 weeks, the maxillary left second molar was moved into the extraction site for 28 days. Dynamic bone microstructures were evaluated using in vivo micro–computed tomography. Micromechanical properties and stress distribution of corresponding tissue were examined by nanoindentation and finite element methods. Mixed-model analysis of variance was performed to compare the difference among time points with Bonferroni post hoc tests at the significance level of P < .05. Results: The BoneCeramic group had the least amount of tooth movement and the highest bone volume fraction, tr...

Objective: To quantify the three-dimensional moments and forces produced by pretorqued nickel-titanium (NiTi) rectangular archwires fully engaged in 0.018- and 0.022-inch slots of central incisor and molar edgewise and prescription brackets. Materials and Methods: Ten identical acrylic dental models with retroclined maxillary incisors were fabricated for bonding with various bracket-wire combinations. Edgewise, Roth, and MBT brackets with 0.018- and 0.022-inch slots were bonded in a simulated 2 × 4 clinical scenario. The left central incisor and molar were sectioned and attached to load cells. Correspondingly sized straight and pretorqued NiTi archwires were ligated to the brackets using 0.010-inch ligatures. Each load cell simultaneously measured three force (Fx, Fy, Fz) and three moment (Mx, My, Mz) components. The faciolingual, mesiodistal, and inciso-occluso/apical axes of the teeth corresponded to the x, y, and z axes of the load cells, respectively. Each wire was removed and retested seven times. Three-way analysis of variance (ANOVA) examined the effects of wire type, wire size, and bracket type on the measured orthodontic load systems. Interactions among the three effects were examined and pair-wise comparisons between significant combinations were performed. Results: The force and moment components on each tooth were quantified according to their local coordinate axes. The three-way ANOVA interaction terms were significant for all force and moment measurements (P < .05), except for Fy (P > .05). Conclusion: The pretorqued wire generates a significantly larger incisor facial crown torquing moment in the MBT prescription compared to Roth, edgewise, and the straight NiTi wire.

OBJECTIVE: To test the effect of alcohol on force decay of elastomeric chains in vitro in order to determine if increasing alcohol concentrations results in an increased amount of elastomeric chain force decay. MATERIALS AND METHODS: A prospective laboratory study was completed to test the effect of alcohol exposure on orthodontic elastomeric chain. A total of 450 specimens were divided into five test groups. Two test groups were each exposed to different alcohol concentrations (14% and 26.9%) and the other two test groups were exposed to different commercially available mouth rinses (Cēpacol -14% alcohol and Listerine - 26.9% alcohol) for 60 seconds twice a day. The control group followed all of the same procedures but was only exposed to deionized (DI) water. Force measurements were taken at six time points (initial, 1 day, 7 days, 14 days, 21 days, and 28 days). RESULTS: There were no significant differences among groups at the initial time point (P = .52). Statistically significant effects of time on force decay were seen in all groups. All test groups showed significantly more force decay than the control group. Only a few statistically significant differences were observed when comparing force decay among the test groups. CONCLUSIONS: Alcohol causes an increase in force decay of elastomeric chain over time. A concentration dependence of alcohol on force decay of elastomeric chain was not observed.

Introduction BoneCeramic (Straumann, Basel, Switzerland) can regenerate bone in alveolar defects after tooth extraction, but it is unknown whether it is feasible to move a tooth through BoneCeramic grafting sites. The objective of this study was to investigate 3-dimensional real-time root resorption and bone responses in grafted sites during orthodontic tooth movement. Methods Sixty 5-week-old rats were randomly assigned to 3 groups to receive BoneCeramic, natural bovine cancellous bone particles (Bio-Oss; Geistlich Pharma, Wolhusen, Switzerland), or no graft, after the extraction of the maxillary left first molar. After 4 weeks, the maxillary left second molar was moved into the extraction site for 28 days. Dynamic bone microstructures and root resorption were evaluated using in-vivo microcomputed tomography. Stress distribution and corresponding tissue responses were examined by the finite element method and histology. Mixed model analysis of variance was performed to compare the differences among time points with Bonferroni post-hoc tests at the significance level of P Results The BoneCeramic group had the least amount of tooth movement and root resorption volumes and craters, and the highest bone volume fraction, trabecular number, and mean trabecular thickness, followed by the Bio-Oss and the control groups. The highest stress accumulated in the cervical region of the mesial roots. Conclusions BoneCeramic has better osteoconductive potential and induces less root resorption compared with Bio-Oss grafting and naturally recovered extraction sites.

To validate whether applying a well-defined initial three-dimensional (3D) load can create consistently expected tooth movement in patients.Twenty-one patients who needed bilateral canine retraction to close extraction space were selected for this split-mouth clinical trial. After initial alignment and leveling, two canines in each patient were randomly assigned to receive either translation (TR) or controlled tipping (CT) load. The load was delivered by segmental T-loops designed to give specific initial moment/force ratios to the canines in each treatment interval (TI), verified with an orthodontic force tester. Maxillary dental casts were made before canine retraction and after each TI. The casts were digitized with a 3D laser scanner. The digital models were superimposed on the palatal rugae region. The 3D canine displacements and the displacement patterns in terms of TR, CT, and torque were calculated for each TI.The method can reliably detect a TR displacement greater than 0.3 mm and a rotation greater than 1.5°. Ninety-two TIs had displacements that were greater than 0.3 mm and were used for further analysis. Most displacements were oriented within ±45° from the distal direction. The displacement pattern in terms of TR or CT was not uniquely controlled by the initial moment/force ratio.The initial load system is not the only key factor controlling tooth movement. Using a segmental T-loop with a well-controlled load system, large variations in canine displacement can be expected clinically.

Objective: To observe the real-time microarchitecture changes of the alveolar bone and root resorption during orthodontic treatment. Materials and Methods: A 10 g force was delivered to move the maxillary left first molars mesially in twenty 10-week-old rats for 14 days. The first molar and adjacent alveolar bone were scanned using in vivo microcomputed tomography at the following time points: days 0, 3, 7, and 14. Microarchitecture parameters, including bone volume fraction, structure model index, trabecular thickness, trabecular number, and trabecular separation of alveolar bone, were measured on the compression and tension side. The total root volume was measured, and the resorption crater volume at each time point was calculated. Univariate repeated measures analysis of variance with Bonferroni corrections were performed to compare the differences in each parameter between time points with significance level at P < .05. Results: From day 3 to day 7, bone volume fraction, structure model index, trabecular thickness, and trabecular separation decreased significantly on the compression side, but the same parameters increased significantly on the tension side from day 7 to day 14. Root resorption volume of the mesial root increased significantly on day 7 of orthodontic loading. Conclusions: Real-time root and bone resorption during orthodontic movement can be observed in 3 dimensions using in vivo micro-CT. Alveolar bone resorption and root resorption were observed mostly in the apical third on day 7 on the compression side; bone formation was observed on day 14 on the tension side during orthodontic tooth movement.

Introduction Suture expansion stimulates bone growth to correct craniofacial deficiencies but has a high potential of treatment relapse. The objective of this study was to investigate whether there is a dose-dependent relationship between the recombinant human bone morphogenetic protein-2 (rhBMP-2) and bone formation during suture expansion. Methods Fifty 6-week-old male New Zealand white rabbits were randomly assigned to 5 groups to receive 0 (control), 0.01, 0.025, 0.1, or 0.4 mg/mL of rhBMP-2 delivered by absorbable collagen sponge placed over the interfrontal suture. The suture was expanded for 33 days by 200 g of constant force via a spring anchored with 2 miniscrew implants. Distance of suture expansion, suture volume, and cross-sectional area after expansion were measured using radiographs with bone markers and microcomputed tomography. Suture widths and mineralization appositional rates were calculated based on the widths between bone labels under an epifluorescent microscope. Software (Multilevel Win 2.0; University of Bristol, Bristol, United Kingdom) was used to model distance of suture expansion over time as polynomials to compare group differences. Wilcoxon signed rank tests were performed to compare the suture volume and cross-sectional area, mineral apposition rate, and suture width between groups. The significance level was set at P = 0.05. Results Whereas the sutures were expanded in all groups, sutures were expanded by significantly greater amounts in the control and the 0.01 mg/mL groups without fusing the sutures than in the 0.025, 0.1, and 0.4 mg/mL groups with fusing sutures. Compared with the controls, the 0.01 mg/mL group showed significantly lower suture volumes, cross-sectional areas, and suture widths after expansion. The mineral apposition rate was significantly higher in the 0.01 mg/mL group than in the controls from days 10 to 30. Conclusions The 0.01 mg/mL dose of rhBMP-2 delivered by absorbable collagen sponge can stimulate bone formation at the bony edges of the suture during suture expansion; however, higher concentrations cause suture fusion. With an appropriate concentration, rhBMP-2 might facilitate suture expansion for clinical uses.

Introduction Microdamage reduces bone mechanical properties and thus could contribute to implant failure. The objective of this study was to investigate whether the diameter of mini-implants affects linear microcrack generation and whether this differs between the mandible and the maxilla because of their contrasting cortical thicknesses. Methods Maxillary and mandibular quadrants of 5 dogs were randomly assigned to receive, in situ, no pilot drilling or mini-implant insertion (control), pilot drilling only without mini-implants, or pilot drilling plus a mini-implant of 1 of 3 diameters: 1.4 mm (n = 18), 1.6 mm (n = 18), and 2.0 mm (n = 18). Linear microcracks were assessed on basic fuchsin-stained sections by using epifluorescence microscopy. Results Pilot drilling without mini-implant insertion produced significantly higher linear microcrack burdens in the mandible compared with the maxilla. In the both the mandible and the maxilla, all implants produced higher linear microcrack burdens than did the controls, yet there were no differences between the 3 implant diameters. Conclusions Neither the diameter of the mini-implant nor the site of insertion (mandible vs maxilla) had a significant effect on the amount of linear microdamage adjacent to the implant when the implants were inserted after pilot drilling in situ.

Suture compression is a widely used approach to inhibit maxillary growth; however, biological responses in sutures to compressive force are still unclear. The objective of this pilot study was to investigate the matrix metalloproteinase (MMP) expression and osteoclast activities during the midpalatal suture compression.56 six-week old male C57BL/6 mice were randomly assigned to the control and compression groups. The mice in the compression and control groups received helix springs bonded to the maxillary molars delivering initial compressive forces of 0.20 and 0N (no activation), respectively. On Days 1, 4, 7 and 14, animals were sacrificed and scanned using micro-computed tomography to quantify suture width and bone mineral density. Serial histological sections were stained with HE, TRAP, and immunohistochemistry to observe changes in bone resorption, osteoclast activities, and MMP-1, 8, and 13 expressions. Bone volume/total volume (Bv/Tv) ratio, osteoclast count, osteoclast covering area, and MMP expression intensity were measured. The Mann-Whitney and the Kruskal-Wallis tests with Bonferroni post-hoc corrections were performed to compare differences between groups and between time points in the same group at significant level of P0.05.Compared to the control, suture width in the compression group was significantly reduced on Day 1, but continuously widened with reduced bone mineral density afterwards. With MMP-1 and -13 evidently intensified expressions, osteoclast number and activities significantly increased, leading to reduced Bv/Tv ratio and progressive bone resorption from Days 4 to 14.Suture compression elevated the MMP-1 and 13 expressions, activated osteoclasts, reduced bone density, and induced bone resorption adjacent to the suture. It suggests that suture compression can be used for bone volume reduction.

Introduction The goal of this study was to evaluate whether human recombinant bone morphogenetic protein-2 (rhBMP-2) enhances sutural bone formation or causes premature sutural fusion. Methods Thirty 6-week-old rabbits underwent midsagittal sutural expansion. The animals were randomly assigned to receive 0 (control), 0.1 mg per milliliter, or 0.4 mg per milliliter of rhBMP-2, delivered by an absorbable collagen sponge placed over the suture. A 100-g constant force was delivered for 33 days by using a nickel-titanium spring to expand the suture between 2 miniscrew implants anchored in the frontal bone. At days 10, 20, and 30, sutural separation was evaluated and modeled over time as polynomials by using multilevel statistical procedures. Bone formation and sutural gaps were analyzed histomorphometrically between days 10 and 20 and days 20 and 30. Results The control group showed significantly greater overall sutural bone formation than did the 2 rhBMP-2 groups. Over time, bone formation decreased significantly in all groups. Between days 10 and 20, the 0.4 mg per milliliter group produced significantly more (58%) bone than did the 0.1 mg per milliliter group; there were no significant differences in bone formation between the 2 experimental groups between days 20 and 30. Both 0.1 and 0.4 mg per milliliter of rhBMP-2 in the absorbable collagen sponge caused premature fusion by forming a bony bridge connecting the ectocranial aspect of the sutural margins. Premature fusion significantly reduced sutural separation between 10 and 30 days (to 56% and 62% of control values for the 0.1 and 0.4 mg per milliliter groups, respectively). There were no significant differences in sutural separation between the 0.1 and 0.4 mg per milliliter groups. Conclusions Compared with the 0.1 mg per milliliter group, 0.4 mg per milliliter of rhBMP-2 accelerated sutural bone formation between days 10 and 20. After 10 to 20 days, rhBMP-2 in the absorbable collagen sponge caused premature sutural fusion, despite the constant expansion forces.