Mission Magazine - Braces get a boost

Braces get a boost

September 2009

by Natalie Gutierrez

For the 5 million in the United States and Canada who wear braces, better oral health, an attractive smile and enhanced self-image are just a few of the benefits. Yet, many orthodontic patients - particularly the one in five who are adults - testify that the much-anticipated date their braces are to be removed is a day they wish would arrive sooner.

A team of orthodontists at The University of Texas Health Science Center at San Antonio hopes to speed up and improve orthodontic treatment using a new device called the AcceleDent.

Dubravko Pavlin, D.M.D., M.S.D., Ph.D., an associate professor in the Department of Orthodontics at the Health Science Center, worked with a team of investigators from OrthoAccel Technologies Inc. of Houston to help develop the device.

His colleagues Ravikumar Anthony, B.D.S., M.D.S., M.S., clinical instructor of orthodontics, and Peter Gakunga, B.D.S., M.S., Ph.D., assistant professor of orthodontics at the Health Science Center, are now incorporating the device in an investigational study at the university.

Dr. Anthony is the lead investigator of this study, which is the largest study of its kind launched this spring.

Brent Tarver, vice president for clinical affairs and technology development at OrthoAccel, is optimistic about the research potential.

"We are excited about this particular investigation because we expect it could lead to U.S. regulatory approval," Tarver said.

The study involves 34 patients ages 12 to 40 who need braces. Patients receive standard orthodontic treatment including any necessary extractions, and are fitted for braces at the Health Science Center Orthodontic Clinic. Once their braces are on, patients are provided with an AcceleDent device to use at home. The device, which stands about
4 inches high and features a wafer-thin mouthpiece attached to a small, sleek battery-operated handle, almost resembles a gizmo from a science fiction movie.

Patients are instructed to place the device in their mouth and bite down for 20 minutes a day during orthodontic treatment. While in the mouth, the device delivers a low-frequency pulsating vibration to the teeth. The vibration is not uncomfortable and barely noticeable to the patient. The researchers believe the vibratory forces, in combination with standard orthodontic treatment, will enhance the metabolism in bone tissue surrounding the teeth, thus allowing the teeth to move and straighten faster and more effectively.

Denice Jimenez uses the AcceleDent device

An earlier model of the AcceleDent is the device used in the current Health Science Center study. Denice Jimenez, an Orthodontic Clinic patient, demonstrates how the AcceleDent device is used.

Vibration therapy has been used in health care since the 1800s. More recently scientists across the world have documented positive results using the therapy in patients with osteoporosis, muscle loss and joint pain. Eight years ago, NASA scientists reported that muscles atrophy relatively quickly and bones lose mass during prolonged exposures to weightlessness. Therefore, they suggested their astronauts might prevent bone loss by standing on a lightly vibrating plate for 10 to 20 minutes each day while in orbit.

"We're taking this same concept and applying it to the orthodontic process," Dr. Pavlin said. "Teeth are surrounded by alveolar bone and are held in place by periodontal ligaments and gum tissue. These respond to applied orthodontic force, which allows for movement of the teeth through the bone. We believe the application of cyclic loading (controlled vibrations) will not only increase the rate of tooth movement, but will also create a solid foundation of bone and adjacent tissues in the mouth and result in more stable outcomes for orthodontic treatment. This approach would allow us to treat patients using either standard metal braces or the plastic removable braces called Invisalign, and to treat more complicated cases with more stable outcomes."

The AcceleDent device, which could significantly shorten orthodontic treatment, will be available on a limited basis in the United Kingdom in late 2009. Representatives at OrthoAccel predict the AcceleDent will be marketed in the United States in late 2010.

To learn more about the study or services provided by the Orthodontic Clinic at the UT Health Science Center Dental School, call (210) 567-0072.

Top Image: OrthoAccel's latest model of the AcceleDent is expected to be marketed in the U.S. in late 2010. Dr. Dubravko Pavlin, associate professor of orthodontics, worked with a national team of investigators to help develop the device.

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