title: Tissue response during Piezocision-assisted tooth movement: a histological study in rats.
abstract: OBJECTIVE
  Piezocision is a novel, minimally invasive technique combining micro-incisions and decortications made by a piezotome in order to enhance the rate of orthodontic tooth movement. The combined technique allows simultaneous hard and/or soft tissue grafting via selective tunnelling to correct gingival recessions or bone deficiencies. The present study was designed to evaluate the effects of Piezocision on bone with or without tooth movement on a rat model.
  
  
  METHODS
  Ninety-four Sprague-Dawley rats were divided into four groups: no treatment (n = 3), TM (tooth movement alone; n = 21), PS (Piezocision alone; n = 35), and PS + TM (Piezocision and tooth movement; n = 35). In each group, seven time points were studied: 1, 3, 7, 14, 28, 42, and 56 days. After sacrifice, the maxillae were removed, defleshed, stained with haematoxylin and eosin for morphometric analyses and tartrate-resistant acid phosphatase for osteoclastic activity.
  
  
  RESULTS
  Three days after the surgery, the bone content decreased significantly in the PS and PS + TM groups compared to baseline (P < 0.01) and the TM group (P < 0.05). This trend continued until Day 28 and was particularly evident in the PS + TM group. At Day 56, alveolar bone returned to its baseline levels in all groups. Osteoclastic activity followed similar change pattern found in the amount of bone, suggesting a strong role for the coupling of the resorptive and formative turnover of the bone. Osteoclastic activity increased as soon as Day 1 in the PS (29.0±3.0, P < 0.05) and PS + TM groups (39.0±6.0, P < 0.01) compared to baseline (22.0±4.0). The highest level of osteoclastic activity in TM group was observed at 3 days (64.3±8.0, P < 0.01) with a steady decrease thereafter. The Piezocision-induced osteoclastic activity showed a steady increase up to 7 days in both PS (39.0±7.0, P < 0.01) and PS + TM (51.8±7.0, P < 0.01) groups and decreased thereafter until Day 56.
  
  
  CONCLUSIONS
  Within the limitations of our study (number of animals, duration in time, and limited data on the anabolic activity), our preliminary results suggest that Piezocision-facilitated orthodontic tooth movement increases the rate of movement of the teeth undergoing orthodontic treatment through the coupled remodelling of the alveolar bone. This process is initiated by the osteoclastic activity following surgery and extended via the synergistic relationship between Piezocision and tooth movement.
authors.affiliation: **Orthodontics, Henry M. Goldman School of Dental Medicine, Boston University, MA and sdibart@bu.edu.
authors.forename: Serge
authors.initials: S
authors.lastname: Dibart
authors.affiliation: **Orthodontics, Henry M. Goldman School of Dental Medicine, Boston University, MA and.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Yee
authors.affiliation: Departments of *Periodontology and Oral Biology and.
authors.forename: Jerome
authors.initials: J
authors.lastname: Surmenian
authors.affiliation: **Orthodontics, Henry M. Goldman School of Dental Medicine, Boston University, MA and.
authors.forename: Jean David
authors.initials: JD
authors.lastname: Sebaoun
authors.affiliation: **Orthodontics, Henry M. Goldman School of Dental Medicine, Boston University, MA and.
authors.forename: Susan
authors.initials: S
authors.lastname: Baloul
authors.affiliation: Departments of *Periodontology and Oral Biology and.
authors.forename: Emilie
authors.initials: E
authors.lastname: Goguet-Surmenian
authors.affiliation: ***Department of Applied Oral Sciences, Center for Periodontology, Forsyth Institute, Cambridge, MA, USA.
authors.forename: Alpdogan
authors.initials: A
authors.lastname: Kantarci
mesh_terms: D000135:Acid Phosphatase / Q000032:analysis; D000539:Alveolar Process / Q000473:pathology / Q000601:surgery; D000818:Animals; D015415:Biomarkers / Q000032:analysis; D016723:Bone Remodeling / Q000502:physiology; D001862:Bone Resorption / Q000503:physiopathology; D007527:Isoenzymes / Q000032:analysis; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D023421:Models, Animal; D008963:Molar / Q000473:pathology; D008964:Molar, Third / Q000473:pathology; D009969:Orthodontic Wires; D010010:Osteoclasts / Q000502:physiology; D059745:Piezosurgery / Q000379:methods*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000071681:Tartrate-Resistant Acid Phosphatase; D013997:Time Factors; D014087:Tooth Movement Techniques / Q000295:instrumentation / Q000379:methods*; D014092:Tooth Root / Q000473:pathology
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase