Pérez Idarraga Alicia, Yeste Ojeda Fara, Virto Ruiz Leire, Lacasa Litner Miguel, Cacho Casado Alberto, Martin Conchita
Department of Orthodontics, Faculty of Odontology University Complutense Madrid Madrid Spain.
Department of Orthodontics Universidad San Pablo CEU Madrid Spain.
Bioeng Transl Med. 2023 Apr 1;8(3):e10491. doi: 10.1002/btm2.10491. eCollection 2023 May.
Application of intermittent forces by vibration is proposed as an easy-to-use accelerator of dental movement. The purpose of this study was to determine the effect of intermittent vibrational force application during orthodontic aligner treatment on receptor activator of nuclear factor-kappa B ligand (RANKL) and osteoprotegerin (OPG) concentrations in crevicular fluid as markers of bone remodeling. This three-arm parallel randomized clinical trial included 45 candidates for malocclusion treatment with aligners, randomly assigned to: Group A (vibrational forces from onset of treatment); Group B (vibrational forces at 6 weeks after treatment onset); or Group C (no vibration). The frequency of aligner adjustment also differed among groups. At different time points, a paper tip was used to draw crevicular fluid samples from a moving lower incisor for RANKL and OPG analysis using ELISA kits. Mixed-model ANOVA found no significant differences in RANKL (A: = 0.31, B: = 0.8, C: = 0.49) or OPG (A: = 0.24, B: = 0.58, C: = 0.59) over time in any group or as a function of the application/non-application of vibration or the frequency of aligner adjustments. Application of this accelerator device did not significantly affect bone remodeling in patients undergoing orthodontic treatment with aligners. However, a nonsignificant improvement in biomarker concentrations was observed when aligners were changed every 7 days and vibration was also applied. Further research is warranted to establish protocols for the application of vibration and the timing of aligner adjustments.
通过振动施加间歇性力被提议作为一种易于使用的牙齿移动加速器。本研究的目的是确定在正畸矫治器治疗期间施加间歇性振动力对龈沟液中核因子-κB受体活化因子配体（RANKL）和骨保护素（OPG）浓度的影响，以此作为骨重塑的标志物。这项三臂平行随机临床试验纳入了45名使用矫治器进行错牙合畸形治疗的患者，随机分为：A组（从治疗开始就施加振动力）；B组（在治疗开始6周后施加振动力）；或C组（不施加振动）。各组矫治器调整的频率也有所不同。在不同时间点，使用纸尖从一颗移动的下切牙采集龈沟液样本，使用酶联免疫吸附测定试剂盒进行RANKL和OPG分析。混合模型方差分析发现，在任何组中，随着时间推移，RANKL（A组： = 0.31，B组： = 0.8，C组： = 0.49）或OPG（A组： = 0.24，B组： = 0.58，C组： = 0.59）均无显著差异，也未因是否施加振动或矫治器调整频率而有显著差异。这种加速器装置的应用对接受矫治器正畸治疗的患者的骨重塑没有显著影响。然而，当每7天更换一次矫治器并施加振动时，生物标志物浓度有不显著的改善。有必要进行进一步研究，以确定振动应用方案和矫治器调整时机。
