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Age effect on orthodontic tooth movement rate and the composition of gingival crevicular fluid

A literature review

Einfluss des Alters auf die Geschwindigkeit der kieferorthopädischen Zahnbewegung und die Zusammensetzung des gingivalen Sulkusfluids

Ein Literaturreview

  • Systematic Reviews and Meta-Analyses
  • Published:
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

To evaluate and form a comprehensive understanding of the effect of patient age on bone remodeling and consequently on the rate of orthodontic tooth movement (OTM).

Methods

A systematic search in PubMed and Embase from 1990 to December 2017 was performed and completed by a hand search. Prospective clinical trials which investigated the rate of OTM and/or studies assessing age-related changes in the composition of gingival crevicular fluid (GCF) in older compared to younger study groups were included. Study selection, data extraction and risk of bias were assessed by two authors.

Results

Eight studies fulfilled the inclusion criteria. Among them, four evaluated the rate of OTM and six investigated mediators in the GCF (prostaglandin E2, interleukin [IL]-1β, IL‑6, IL‑1 receptor antagonist, receptor activator of nuclear factor kappa‑Β ligand, osteoprotegerin, granulocyte–macrophage colony-stimulating factor, pentraxin 3). Patient age ranged between 16 and 43 years for older and <16 years for younger groups. In most of the studies, the younger patients showed faster OTM in the first phase of treatment and more pronounced cytokine levels. Older patients had a delayed reaction to orthodontic forces.

Conclusion

The small number of included studies and large heterogeneity in study design give limited clinical evidence that the older patients are less responsive to orthodontic force in comparison to younger patients. The initial cellular response to orthodontic force is expected to be delayed in older patients. Control intervals during orthodontic treatment should be adjusted to the individual’s treatment response.

Zusammenfassung

Ziel

Das Ziel dieses Reviews war die Einschätzung und Entwicklung eines umfassenden Verständnisses des Einflusses des Patientenalters auf den Knochenumbau und folglich auf die Geschwindigkeit der kieferorthopädischen Zahnbewegung (OTM).

Methoden

Es wurde eine systematische Suche in PubMed und Embase im Zeitraum von 1990 bis Dezember 2017 durchgeführt, ergänzt durch eine Handsuche. Prospektive klinische Studien zum Vergleich der Geschwindigkeit der OTM und/oder Studien zu altersabhängigen Veränderungen in der Zusammensetzung des gingivalen Sulkusfluids (GCF) bei älteren und jüngeren Probandengruppen wurden inkludiert. Die Studienauswahl, Datenextraktion und Bewertung des Risikos für Bias erfolgte durch 2 der Studienautoren.

Ergebnisse

Acht Studien erfüllten die Einschlusskriterien. Vier von ihnen ermittelten die Geschwindigkeit der kieferorthopädischen Zahnbewegung und 6 untersuchten Mediatoren im GCF (Prostaglandin E2, Interleukin [IL]-1β, IL‑6, IL-1-Rezeptorantagonist, „receptor activator of nuclear factor κ‑Β ligand“, Osteoprotegerin, „granulocyte-macrophage colony-stimulating factor“, Pentraxin 3). Die ältere Probandengruppe war 16–43 Jahre alt, die jüngeren Patienten wiesen ein Alter von <16 Jahren auf. Bei den jüngeren Patienten wurden in der Mehrzahl der Studien eine initial schnellere Zahnbewegung und höhere Zytokinspiegel festgestellt. Die älteren Probanden zeigten eine verzögerte Reaktion auf orthodontische Kräfte.

Schlussfolgerung

Aufgrund der geringen Studienzahl und der Heterogenität der Studiendesigns ist die klinische Evidenz für eine verminderte Reaktion auf kieferorthopädische Kräfte bei älteren im Vergleich zu jüngeren Patienten eingeschränkt. Die initialen zellulären Reaktionen scheinen bei älteren Patienten verzögert abzulaufen. Kontrollintervalle während der kieferorthopädischen Behandlung sollten an das individuelle Reaktionsverhalten angepasst werden.

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Authors and Affiliations

  1. Private practice, Berlin, Germany

    Anne Schubert &  Fabian Jäger

  2. Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center Nijmegen, 6500, HB Nijmegen, The Netherlands

    Jaap C. Maltha PhD

  3. Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité Centrum 3, Charité – Universitätsmedizin Berlin, Aßmannshauser Str. 4–6, 14197, Berlin, Germany

    Theodosia N. Bartzela MSc, PhD

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  1. Anne Schubert
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  3. Jaap C. Maltha PhD
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Correspondence to Theodosia N. Bartzela MSc, PhD.

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A. Schubert, F. Jäger, J.C. Maltha and T.N. Bartzela declare that they have no competing interests.

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For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case. For this type of study informed consent is not required.

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Schubert, A., Jäger, F., Maltha, J.C. et al. Age effect on orthodontic tooth movement rate and the composition of gingival crevicular fluid. J Orofac Orthop 81, 113–125 (2020). https://doi.org/10.1007/s00056-019-00206-5

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