Biological Response to Translation in Accelerated Invisalign®: A Pilot Study

Objectives: Previous clinical trials suggest orthodontic patients assigned to an accelerated Invisalign® schedule and patients using the AcceleDent ® Aura device will experience accelerated tooth movement. We hypothesize accelerated Invisalign® plus AcceleDent® application can synergistically accelerate tooth movement. Bone remodeling is controlled by balance between resorption and formation activities, which are regulated via TNFSF11 (RANKL) binding, TNFRSF11B (OPG) production and other cytokines. Gingival-crevicular fluid(GCF) analysis is a noninvasive, practical sampling procedure to observe molecular-mediators. Therefore, the purpose of this pilot study is to investigate the relationship between the levels of IL1B, IL6, TNFA, TNFRSF11B and TNFSF11 expression with the extent of tooth movement in accelerated Invisalign® with and without AcceleDent® treatment.
Methods: Four (from a plan to recruit 30) patients treated in the UNC Graduate Orthodontic Clinic were recruited (UNC IRB 216-0167). Inclusion/exclusion criteria were applied. Two groups were randomized; each on a 4-day aligner schedule with one group receiving AcceleDent® treatment. Digital scanning of the dentition and non-invasive sampling of GCF was completed at baseline, 4-days and 2-weeks. Tooth movement distances were evaluated using Geomagic software. GCF samples were processed via Multiplex-Luminex Platform. IL1B, IL6, TNFA, TNFRSF11B and TNFSF11 concentrations in GCF are expressed as mean+SD. Results are expressed as the Pearson correlation and the p-value.
Results: This preliminary data demonstrates a marginally significant increase in levels of IL1B associated with the amount of tooth movement from baseline to the 4-day time point for both groups. No significant association of other cytokines or TNFRSF11B and TNFS11 to tooth translation in either group was found.
Conclusions: The synergistic effects of accelerated Invisalign® and AcceleDent® application have not been determined via molecular biomarkers due to the current small sample size. This study is ongoing and recruiting patients. Supported by AADR Student Research Fellowship (SHL).