SEARCH WITHIN CONTENT
Citation Information : Australasian Orthodontic Journal. Volume 31, Issue 2, Pages 171-177, DOI: https://doi.org/10.21307/aoj-2020-152
License : (CC BY 4.0)
Published Online: 15-August-2021
Aim: The aim of the present study was to evaluate and compare changes in pulpal blood flow (PBF) as a result of maxillary incisor intrusion achieved by one of two methods (utility arches or mini-implants).
Materials and methods: Thirty subjects were divided into three groups, the first of which underwent maxillary incisor intrusion using utility arches (UA) and a second group, intrusion via mini-implants (MI). The third group acted as a control. An intrusive force of 100 g was applied to the upper incisors in the treatment groups, whereas no force was applied to the anterior teeth in the control group. A laser Doppler flowmeter (LDF) was used to measure PBF at baseline (T0) and during incisor intrusion at 24 hours (T1), three days (T2), seven days (T3) and three weeks (T4). Statistical changes in PBF were assessed by the Wilcoxon Signed Rank and Mann-Whitney U tests, with significance set at p < 0.05.
Results: The mean PBF in the UA and MI groups decreased significantly from T0 to T1 (p < 0.001), slightly increased at T2 and continued to increase gradually at T3. PBF attained levels similar to those measured prior to intrusion at T4. No significant changes in PBF were observed in the control group over the course of the study. The only statistically significant difference between the UA and MI groups were at T1 and T2, at which time the MI group had lower PBF values (p < 0.001).
Conclusions: Despite slight regressive changes in pulpal tissue observed over the short term, PBF values tended to return to initial levels within three weeks, indicating that changes observed in PBF with the UA and MI intrusion methods are reversible. Although the changes in PBF could not be directly related to the method of intrusion employed, in general, a more severe drop in PBF was observed in the MI group during the first three days of intrusion.
1. Weiland FJ, Bantleon H, Droschl H. Evaluation of continuous arch and segmented arch leveling techniques in adult patients—a clinical study. Am J Orthod Dentofac Orthop 1996;110:647-52.
2. Burstone CJ. Deep overbite correction by intrusion. Am J Orthod 1977;72:1-22.
3. Bench RW, Gugino CF, Hilgers JJ. Bioprogressive therapy part 6. J Clin Orthod 1978;12:123-39.
4. Begg PR, Kesling PC. Begg orthodontic theory and technique. Philadelphia: WB Saunders, 1977.
5. Polat-Özsoy Ö, Arman-Özçırpıcı A, Veziroğlu F, Çetinşahin A. Comparison of the intrusive effects of miniscrews and utility arches. Am J Orthod Dentofacial Orthop 2011;139:526-32.
6. Ohnishi H, Yagi T, Yasuda Y, Takada K. A mini-implant for orthodontic anchorage in a deep overbite case. Angle Orthod 2005;75:444-52.
7. Kanomi R. Mini-implant for orthodontic anchorage. J Clin Orthod 1997;31:763-7.
8. Hans MG, Kishiyama C, Parker SH, Wolf GR, Noachtar R. Cephalometric evaluation of two treatment strategies for deep overbite correction. Angle Orthod 1994;64:265-74.
9. Weiland FJ, Bantleon HP, Droschl H. Evaluation of continuous arch and segmented arch leveling techniques in adult patients—a clinical study. Am J Orthod Dentofacial Orthop 1996;110:647-52.
10. Anstendig HS, Kronman JH. A histologic study of pulpal reaction to orthodontic tooth movement in dogs. Angle Orthod 1972;42:50-5.
11. Unsterseher RE, Nieberg LG, Weimer AD, Dyer JK. The response of human pulpal tissue after orthodontic force application. Am J Orthod Dentofacial Orthop 1987;92:220-4.
12. Guevara MJ, McClugage SG Jr. Effects of intrusive forces upon the microvasculature of the dental pulp. Angle Orthod 1980;50:129-34.
13. Kvinnsland S, Heyeraas K, Ofjord ES. Effect of experimental tooth movement on periodontal and pulpal blood flow. Eur J Orthod 1989;11:200-5.
14. Vandevska-Radunovic V, Kristiansen AB, Heyeraas KJ, Kvinnsland S. Changes in blood circulation in teeth supporting tissues incident to experimental tooth movement. Eur J Orthod 1994;16:361-9.
15. Gazelius B, Olgart L, Edwall B, Edwall L. Non-invasive recording of blood flow in human dental pulp. Endod Dent Traumatol 1986;2:219-21.
16. Vongsavan N, Matthews B. Experiments on extracted teeth into the validity of using laser Doppler techniques for recording pulpal blood flow. Arch Oral Biol 1993;38:431-9.
17. Sano Y, Ikawa M, Sugawara J, Horiuchi H, Mitani H. The effect of continuous intrusive force on human pulpal blood flow. Eur J Orthod 2002;24:159-66.
18. Alakus Sabuncuoglu F, Ersahan S. Changes in maxillary incisor dental pulp blood flow during intrusion by mini-implants. Acta Odontol Scand 2014;72:489-96.
19. Barwick PJ, Ramsay DS. Effect of brief intrusive force on human pulpal blood flow. Am J Orthod Dentofacial Orthop 1996;110:273-9.
20. Ikawa M, Fujiwara M, Horiuchi H, Shimauchi H. The effect of short-term tooth intrusion on human pulpal blood flow measured by laser Doppler flowmetry. Arch Oral Biol 2001;46:781-7.
21. Kumar V, Abbas AK, Fausto N. Robbins and Cotran pathologic basis of disease. 7th edn. Philadelphia, PA: Elsevier Saunders, 2005;5-116.
22. Norer B, Kranewitter R, Emshoff R. Pulpal blood-flow characteristics of maxillary tooth morphotypes as assessed with laser Doppler flowmetry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:88-92.
23. Ersahan Eroglu S, Alakus Sabuncuoglu F. Changes in dental pulp blood flow of different maxillary tooth types after Le Fort I osteotomy. J Craniofacial Surg 2014;25:420-4.
24. Stenvik A, Mjör IA. Pulp and dentine reactions to experimental tooth intrusion. A histologic study of the initial changes. Am J Orthod 1970;57:370-85.
25. Butcher EO, Taylor AC. The vascularity of the incisor pulp of the monkey and its alteration by tooth retraction. J Dent Res 1952;31:239-47.
26. Krishnan V, Park Y, Davidovitch Z. Biology of orthodontic tooth movement: an overview. In: Krishnan V, Davidovitch Z, eds. Biological mechanisms of tooth movement. Chichester, UK: WileyBlackwell, 2009:19-43.
27. Konno Y, Daimaruya T, Iikubo M, Kanzaki R, Takahashi I, Sugawara J et al. Morphological and hemodynamic analysis of dental pulp in dogs after molar intrusion with the skeletal anchorage system. Am J Orthod Dentofacial Orthop 2007;132:199-207.
28. Brodin P, Linge L, Aars H. Instant assessment of pulpal blood flow after orthodontic force application. J Orofac Orthop 1996;57:306-9.
29. Nixon CE, Saviano JA, King GJ, Keeling SD. Histomorphometric study of dental pulp during orthodontic tooth movement. J Endod 1993;19:13-6.
30. Tang MP, Sims MR. A TEM analysis of tissue channels in normal and orthodontically tensioned rat molar periodontal ligament. Eur J Orthod 1992;14:433-44.
31. Warita H. Intravital and electron microscopic observations on increased vascular permeability to light mechanical stimulation. Kokubyo Gakkai Zasshi 1990;57:520-48.
32. Tønder KJ. Vascular reactions in the dental pulp during inflammation. Acta Odontol Scand 1983;41:247-56.
33. Derringer KA, Jaggers DC, Linden RW. Angiogenesis in human dental pulp following orthodontic tooth movement. J Dent Res 1996;75:1761-6.
34. Grünheid T, Morbach BA, Zentner A. Pulpal cellular reactions to experimental tooth movement in rats. Oral Surg Med Oral Pathol Oral Radiol Endod 2007;104:434-41.
35. Rohaya MAW, Shahrul Hisham ZA, Khazlina K. Preliminary study of aspartate aminotransferase activity in gingival crevicular fluids during orthodontic tooth movement. J Appl Sci 2009;9:1393-6.
36. Marshall JA. A study of bone and tooth changes incident to experimental tooth movement and its application to orthodontic practice. Int J Orthodontics 1933;19:l-21.
37. Spector JK, Rothenhaus B, Herman RI. Pulpal necrosis following orthodontic therapy. Report of two cases. NY State Dent J 1974;40:30-2.
38. Raiden G, Missana L, Santamaria de Torres E, Kozuszko S, Pedroso R. Pulpal response to intrusive orthodontic forces. Acta Odontol Latinoam 1998;11:49-54.
39. Lesaffre E, Philstrom B, Needleman I, Worthington H. The design and analysis of split-mouth studies: what statisticians and clinicians should know. Stat Med 2009;28:3470-82.
40. Ramsay DS, Artun J, Martinen SS. Reliability of pulpal bloodflow measurements utilizing laser-Doppler flowmetry. J Dent Res 1991;70:1427-30.
41. Vongsavan N, Matthews B. The vascularity of dental pulp in cats. J Dent Res 1992;71:1913-5.
42. Mathews B, Amess TR, Andrew D, Son D. Non-pulpal component of laser Doppler blood flow signal from human teeth. J Dent Res 1994;73:287 (IADR Abstr 1984).
43. Alakus Sabuncuoglu F, Ersahan S. Changes in maxillary molar pulp blood flow during orthodontic intrusion. Aust Orthod J 2014;30:152-60.
44. Hartmann A, Azérad J, Boucher Y. Environmental effects on laser Doppler pulpal blood-flow measurements in man. Arch Oral Biol 1996;41:333-9.
45. Anderson KK, Vanarsdall RL, Kim S. Measurement of pulpal blood flow in humans using laser Doppler flowmetry: a technique allowing stability and repeatability of pulpal blood flow measurement during surgical manipulations. Int J Adult Orthodon Orthognath Surg 1995;10:247-54.