acific Coast Society of Orthodontists Bulletin Summer 2018 - 53

Resident Research Review

due to the superior aesthetics and comfort that
removable clear aligners provide over traditional
full bonded fixed appliances. Recently, some
clinicians have reported that the clear aligner
system can effectively treat open bites with high
mandibular plane angles, without extruding
posterior teeth, by incorporating intrusive forces.
The research efforts of assistant professor Dr.
Kimberly Mahood and Dr. Bella Shen have been
highlighted here in our department. Their study
suggests that clear aligner therapy is as effective
as fixed appliance therapy in maintaining the
vertical dimension and in correcting anterior
open bites in adult hyper-divergent patients.6
In our current media climate, dictating the need
for best results with minimal effort in the shortest amount of time, patients are looking for
faster, more efficient treatment that leads to an
esthetically pleasing result. For these reasons,
marketing agencies have found different treatment modalities that claim "faster orthodontic
tooth movement." These include, but are not limited to, vibratory stimulation of the tooth roots,
light-induced tooth movement, and microperforations performed into the cortical bone to
induce inflammation/orthodontic tooth movement. We are currently evaluating three of the
most popular acceleratory mechanisms: Acceledent®, Vpro5 (higher frequency vibrations), and
Propel microperforations. Our goal is to determine whether patients saw decreased treatment
times compared to non-accelerated but similar

Figure 6. Two popular acceleratory mechanisms include a vibrational device (Acceledent,
left), and microperforations within the cortical bone (Propel, right).

Summer 2018  PCSO Bulletin

treatment. We will evaluate the quality of treatment results using new software, Quantify,
which was developed by Align Technology. This
software can measure tooth positions with six
degrees of freedom using the baseline pretreatment scan compared with the refinement scan
(Figure 6) and the posttreatment scan. A major
goal is to compare tooth positions of the first
refinement scan to the final ClinCheck accepted
to determine what percent of the planned tooth
movement was actually achieved.
Craniofacial Genetics and Stem Cell Research
The Pacific Regenerative Dentistry Laboratory, led
by Dr. Miroslav Tolar, has focused on identification
of biomarkers associated with orthodontic tooth
movement. This investigation involved collection
of gingival crevicular fluid (GCF) from orthodontic patients treated with Invisalign and examination of the dynamics of biomarkers in different
periods of tooth movement (Figure 7). Dr. Tolar's
current investigation concentrates on the analysis
of cellular responses to orthodontic force. Using a
culture chamber in order to mimic chemical and
mechanical tissue conditions associated with
tooth movement and molecular biological methods to follow intracellular changes that occur in
human periodontal ligament stem cells, we are
specifically focusing on acute endoplasmic reticulum stress and mechanisms of cellular recovery.
The goal of these studies is to identify dynamics
of cellular responses to orthodontic forces that
could not be studied in a patient.

Figure 7. TGCF is collected by apposition of
Periopaper (Oraflow) to a sulcus for 30 seconds.
The volume of collected fluid is measured by
Periotron.

Table of Contents for the Digital Edition of acific Coast Society of Orthodontists Bulletin Summer 2018