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Immune Changes Induced by Orthodontic Forces: A Critical Review
S Chaushu1, Y Klein1,2, O Mandelboim3
1Department of Orthodontics, Faculty of Dental Medicine, The Hebrew University and Hadassah Medical Center, Jerusalem, Israel.
Journal of Dental Research
|June 9, 2021
Summary
Orthodontic tooth movement involves inflammatory responses and immune cell activity. Understanding these processes is key to controlling tooth movement and preventing complications like tissue loss.
Area of Science:
- Immunology
- Orthodontics
- Periodontal tissue biology
Background:
- Orthodontic tooth movement (OTM) relies on mechanical forces triggering inflammatory responses in periodontal tissues.
- Current understanding primarily focuses on acute inflammation driving initial bone resorption, with later phases less understood.
Purpose of the Study:
- To critically review immune processes in OTM-induced inflammation.
- To elucidate the relationship between inflammation and OTM phases.
- To offer novel insights into immune cell roles throughout OTM.
Main Methods:
- Literature review of existing studies on OTM and immune responses.
- Analysis of innate and adaptive immune cell involvement.
- Examination of inflammatory mediators and their impact on bone remodeling.
Main Results:
- Initial OTM phase driven by acute inflammation and innate immune cells (granulocytes, NK, dendritic, γδT cells).
- Lag phase shows incomplete resolution with elevated M1/M2 macrophage and RANKL/OPG ratios, enabling tissue formation.
- Acceleration phase involves chronic inflammation and adaptive immunity (B and T cells) driving simultaneous bone resorption and apposition.
Conclusions:
- Immune responses dynamically shift from innate to adaptive during OTM.
- Partial resolution in the lag phase is crucial for homeostasis, but persistent force can lead to chronic inflammation.
- Dysregulated immune responses or excessive force can cause maladaptive homeostasis and tissue loss, highlighting the need for immunomodulatory strategies.
