Pharmacological Influences on Orthodontic Tooth Movement

Orthodontic tooth movement (OTM) is achieved through the application of controlled mechanical forces that induce remodelling of the periodontal ligament and adjacent alveolar bone. Pharmacological agents can modulate this process by altering the activity or viability of osteoclasts and osteoblasts, by influencing local inflammatory mediators or by modifying cellular signalling pathways. Bisphosphonates and other antiresorptive drugs reduce osteoclast-mediated bone resorption and thus decelerate tooth movement, while analgesic and anti-inflammatory medications such as non-steroidal anti-inflammatory drugs (NSAIDs) may hinder cytokine-driven remodelling. More recently, targeted biologics and growth factors have been investigated for their capacity to fine-tune bone turnover, offering potential routes to accelerate treatment, minimise relapse and personalise orthodontic care. Understanding these pharmacological influences is crucial for optimising force application, predicting treatment duration and mitigating adverse effects on tooth stability and periodontal health.

Research from Nature Portfolio

Recent investigations have explored the impact of bisphosphonate therapy on OTM in vivo. Intravenous administration of zoledronic acid at clinical and supraclinical doses markedly reduced the rate of orthodontic displacement in rodent models. This reduction was accompanied by a pronounced decrease in osteoclast numbers, attenuated alveolar bone resorption and diminished root surface lacunae. Histological and microtomographic analyses further revealed increased areas of necrosis and reduced vascularisation within the periodontal ligament, highlighting potential compromises in tissue vitality. These findings demonstrate the potent antiresorptive action of bisphosphonates on OTM and underscore the need to balance therapeutic benefits with periodontal health considerations.

Pharmacological Influences on Orthodontic Tooth Movement publication trend

The graph below shows the total number of articles in pharmacological influences on orthodontic tooth movement across all publications each year (not limited to Nature Index journals).

Technical terms

Osteoclast: A specialised multinucleated cell responsible for bone resorption during remodelling.

Periodontal ligament (PDL): The fibrous connective tissue anchoring the tooth root to the alveolar bone and transmitting mechanical forces.

RANKL: Receptor activator of nuclear factor κB ligand, a cytokine essential for osteoclast differentiation and activation.

M-CSF: Macrophage colony-stimulating factor, a growth factor required for survival and proliferation of osteoclast precursors.

GDF15: Growth differentiation factor 15, a TGF-β superfamily member that modulates inflammatory and senescence-associated responses in PDL cells.

References

1. The effect of high concentration of zoledronic acid on tooth induced movement and its repercussion on root, periodontal ligament and alveolar bone tissues in rats. Scientific Reports (2021).
2. GDF15 Modulates the Zoledronic-Acid-Induced Hyperinflammatory Mechanoresponse of Periodontal Ligament Fibroblasts. Cells (2024).
3. The influence of non-steroidal anti-inflammatory drugs and paracetamol used for pain control of orthodontic tooth movement: a systematic review. Anais da Academia Brasileira de Ciências (2017).
4. Establishment of an orthodontic retention mouse model and the effect of anti-c-Fms antibody on orthodontic relapse. PLOS ONE (2019).