Mechanobiology of orthodontic tooth movement: An update.

The purpose of this review is to provide an update on the changes at the cellular and tissue level occurring during orthodontic force application. For the understanding of this process, knowledge of the mechanobiology of the periodontal ligament and the alveolar bone are essential. The periodontal ligament and alveolar bone make up a functional unit that undergoes robust changes during orthodontic tooth movement. Complex molecular signaling is responsible for converting mechanical stresses into biochemical events with a net result of bone apposition and/or bone resorption. Despite an improved understanding of mechanical and biochemical signaling mechanisms, it is largely unknown how mechanical stresses regulate the differentiation of stem/progenitor cells into osteoblast and osteoclast lineages. To advance orthodontics, it is crucial to gain a better understanding of osteoblast differentiation from mesenchymal stem/progenitor cells and osteoclastogenesis from the hematopoietic/monocyte lineage

Volumetric changes in the upper airway on CBCT after dentofacial orthopedic interventions - a systematic review.

OBJECTIVE To provide a critical overview of the effect of various orthodontic and/or dentofacial orthopedic interventions on three-dimensional volumetric changes in the upper airway. MATERIALS AND METHODS Four databases were searched for clinical studies concerning 3D volumetric assessments based on CBCT before and after orthodontics interventions. The quality of the studies was assessed using the quality assessment tool of the National Heart, Lung and Blood Institute. After the use of inclusion and exclusion criteria, the pre-and post-treatment volumes were used to visualize the effect of various orthodontics interventions. RESULTS A total of 48 studies were included in this review and none of which were RCTs. The quality of all included studies was assessed as medium. Overall, there is a tendency for an increase in airway volumes after various orthodontic interventions, except for studies concerning extraction therapy with fixed appliances in adults, in which both increases and decreases in airway volumes have been reported. CONCLUSION Orthodontic treatment by growth modification and non-extraction therapy with fixed appliances, regardless of the malocclusion, generally showed positive effects on the airway volume. Orthodontic treatment in combination with extractions does not provide an unambiguous insight. A consensus on the methodology of the airway measurement and nomenclature is urgently needed in order to gain insight into the effect of different interventions on three-dimensional airway changes. CLINICAL RELEVANCE Various orthodontic treatments do not negatively influence the upper airway volume. However, extraction therapy in adults should be chosen with caution, especially in subjects belonging to a group susceptible to airway obstruction

Dentist and orthodontist. A vision for the future

The Advisory Committee on the future of dentistry in the Netherlands recommends to deliver dental care through oral health care teams consisting of dental hygienists, dental assistants and other oral health care workers with extended qualifications with a new dental professional, the oral physician, as the director of those teams. What does this mean for the orthodontist?As modern orthodontics is far more multidisciplinary than in the past a structured collaboration between the orthodontist and the oral physician under one roof will be the future, probably supported by a management service organisation. Furthermore a quality system for orthodontic professionalssuch as the one that was developed though the EURO-QUAl-network needs to be established. And finally, orthodontists should change their clinical behaviour by applying evidence-based treatment strategies. It is clear that these developments need to be tailored in a European context

Dentist and orthodontist. A vision for the future

The Advisory Committee on the future of dentistry in the Netherlands recommends to deliver dental care through oral health care teams consisting of dental hygienists, dental assistants and other oral health care workers with extended qualifications with a new dental professional, the oral physician, as the director of those teams. What does this mean for the orthodontist?As modern orthodontics is far more multidisciplinary than in the past a structured collaboration between the orthodontist and the oral physician under one roof will be the future, probably supported by a management service organisation. Furthermore a quality system for orthodontic professionalssuch as the one that was developed though the EURO-QUAl-network needs to be established. And finally, orthodontists should change their clinical behaviour by applying evidence-based treatment strategies. It is clear that these developments need to be tailored in a European context