Periodontal response to nonsurgical accelerated orthodontic tooth movement

Tooth movement is a complex process involving the vascularization of the tissues, remodeling of the bone cells, and periodontal ligament fibroblasts under the hormonal and neuronal regulation mechanisms in response to mechanical force application. Therefore, it will inevitably impact periodontal tissues. Prolonged treatment can lead to adverse effects on teeth and periodontal tissues, prompting the development of various methods to reduce the length of orthodontic treatment. These methods are surgical or nonsurgical interventions applied simultaneously within the orthodontic treatment. The main target of nonsurgical approaches is modulating the response of the periodontal tissues to the orthodontic force. They stimulate osteoclasts and osteoclastic bone resorption in a controlled manner to facilitate tooth movement. Among various nonsurgical methods, the most promising clinical results have been achieved with photobiomodulation (PBM) therapy. Clinical data on electric/magnetic stimulation, pharmacologic administrations, and vibration forces indicate the need for further studies to improve their efficiency. This growing field will lead to a paradigm shift as we understand the biological response to these approaches and their adoption in clinical practice. This review will specifically focus on the impact of nonsurgical methods on periodontal tissues, providing a comprehensive understanding of this significant and understudied aspect of orthodontic care.