Modulators for orthodontic tooth movement

Background: Orthodontic tooth movement (OTM) is an interaction between the mechanical forces applied on the tooth and the response of biological tissues of the oral cavity to those forces. Bone has the ability of self-repair as well as it can adapt to changes in the mechanical needs of the body. The triggering factor for OTM is a strain on the periodontal ligament (PDL). Mechanical forces applied in orthodontic treatment cause the physical distortion of PDL and alveolar bone cells resulting in activation of inflammatory pathways, such as the prostaglandin pathway. Osteoclast formation has seen to be increased after the activation of T-cells, whereas the food derivatives such as sulforaphane and natural isothiocyanate are observed to promote osteoblastic activity. However, these agents get flushed by blood circulation rapidly. Although, there is a possibility that the agents that enhance bone formation and bone resorption can accelerate tooth movement and shorten the time of orthodontic therapy. Aim: The objective of the review is to highlight the inflammatory process involved in the orthodontic treatment as well as bone remodeling, ultimately to understand how modulation of the inflammatory process of the immune system with the help of external agents can enhance the OTM. Conclusion: The advantages of inflammatory mediators can be utilized in orthodontic therapy that can give a novel perspective to orthodontic treatment. However, this demands a thorough understanding of the biology of oral tissues at cellular as well as molecular level as our knowledge is limited in this perspective. Therefore, more studies and research work should be motivated in the field of oral biology to bring better treatment outcomes in less amount of time. Clinical Significance: The understanding of concepts related to inflammatory processes as well as bone remodeling will help us to develop modulators in future that will resolve the problem of extended treatment time involved in orthodontic treatment. Hence, the knowledge of cellular biology can be applied to make orthodontic more efficient by reducing the treatment time as well as events of relapse