通过局部施用生物功能分子增强正畸牙齿移动(OTM)变得越来越重要,特别是对于寻求审美和功能改善的成年患者。这篇全面的系统综述分析了各种生物功能分子在调节OTM中的功效,着眼于管理方法及其可行性,特别是考虑到局部应用的潜力。在多个数据库中进行的搜索产生了36篇实验人类和动物OTM模型的原始文章,研究了能够干扰正畸治疗期间引起牙齿移动的生化反应的生物功能分子,通过它们对骨代谢的影响加速OTM速率(骨化三醇,前列腺素,重组人松弛素,RANKL和RANKL表达质粒,生长因子,PTH,骨钙蛋白,维生素C和E,生物相容性还原氧化石墨烯,外源性甲状腺素,硬化蛋白,一种特定的EP4激动剂(ONO-AE1-329),角叉菜胶,和草药提取物)。结果表明,在加速OTM方面具有可变的功效,骨化三醇,前列腺素(PGE1和PGE2)RANKL,生长因子,和PTH,其中,显示出有希望的结果。PGE1,PGE2和骨化三醇实验在人类和动物研究中具有统计学意义,而其他分子只接受动物试验,它们可以在未来被验证为人类使用。值得注意的是,只有一项动物研究探索了局部给药,这也表明了未来的研究方向。这篇综述得出结论,虽然某些生物功能分子显示出OTM增强的潜力,证据不是确定的。开发适合人类使用的局部制剂可以提供一种对患者友好的注射替代方案,强调舒适性和成本效益。未来的研究应该集中在克服目前的方法学局限性和推进转化研究,以证实这些生物分子在临床正畸实践中的有效性和安全性。
Enhancement of orthodontic tooth movement (OTM) through local administration of biofunctional molecules has become increasingly significant, particularly for adult patients seeking esthetic and functional improvements. This comprehensive systematic
review analyzes the efficacy of various biofunctional molecules in modulating OTM, focusing on the method of administration and its feasibility, especially considering the potential for topical application. A search across multiple databases yielded 36 original articles of experimental human and animal OTM models, which examined biofunctional molecules capable of interfering with the biochemical reactions that cause tooth movement during orthodontic therapy, accelerating the OTM rate through their influence on bone metabolism (Calcitriol, Prostaglandins, Recombinant human Relaxin, RANKL and RANKL expression plasmid, growth factors, PTH, osteocalcin, vitamin C and E, biocompatible reduced graphene oxide, exogenous thyroxine, sclerostin protein, a specific EP4 agonist (ONO-AE1-329), carrageenan, and herbal extracts). The results indicated a variable efficacy in accelerating OTM, with Calcitriol, Prostaglandins (PGE1 and PGE2), RANKL, growth factors, and PTH, among others, showing promising outcomes. PGE1, PGE2, and Calcitriol experiments had statistically significant outcomes in both human and animal studies and, while other molecules underwent only animal testing, they could be validated in the future for human use. Notably, only one of the animal studies explored topical administration, which also suggests a future research direction. This
review concluded that while certain biofunctional molecules demonstrated potential for OTM enhancement, the evidence is not definitive. The development of suitable topical formulations for human use could offer a patient-friendly alternative to injections, emphasizing comfort and cost-effectiveness. Future research should focus on overcoming current methodological limitations and advancing translational research to confirm these
biomolecules\' efficacy and safety in clinical orthodontic practice.