Tissue reaction to orthodontic tooth movement in acute and chronic corticosteroid treatment.

OBJECTIVES: To study tissue reaction to orthodontic loading during the course of short- and long-term corticosteroid administration.
DESIGN: 'Split-mouth' design to perform orthodontic tooth movement in 64 six-month-old male rats divided into groups: no drug administration (n = 19), acute (n = 22) and chronic (n = 23) 8 mg/kg/day corticosteroid treatment. Performed in the Department of Orthodontics at Aarhus University. EXPERIMENTAL VARIABLE: The upper left first molar was moved for 21 days. Bone markers were administered at 7 and 2 days before sacrifice. Histological sections were cut at the coronal level. OUTCOME MEASURE: Tooth movement rate, alveolar socket area, the relative extension of alveolar wall with erosion, and the mineralizing surfaces were measured and compared in the three groups.
RESULTS: Tooth movement rate increased in the chronic group. The mechanical load induced an enlargement of the alveolar wall that was less pronounced in both medicated groups. In the acute group the drug suppressed bone resorption and formation without mechanical stimulus. Force application resulted in significant increase in the relative extension of resorption and formation in both drug groups; it was particularly pronounced in the chronic group.
CONCLUSION: Because acute corticosteroid ingestion reduces bone turnover, in these patients orthodontic treatment might best be postponed until a time the patient is free of the drug. Chronic steroid ingestion leads to an increased biological reaction to mechanical perturbation indicating that the orthodontic force level should be reduced and controlled more frequently in patients on chronic steroid treatment.