Computational and clinical investigation on the role of mechanical vibration on orthodontic tooth movement

The aim of this study is to investigate the biomechanics for orthodontic tooth movement (OTM) subjected to concurrent single-tooth vibration (50Hz) with conventional orthodontic force application, via a clinical study and computational simulation. Thirteen patients were recruited in the clinical study, which involved distal retraction of maxillary canines with 1.5N (150g) force for 12weeks. In a split mouth study, vibration and non-vibration sides were randomly assigned to each subject. Vibration of 50Hz, of approximately 0.2N (20g) of magnitude, was applied on the buccal surface of maxillary canine for the vibration group. A mode-based steady-state dynamic finite element analysis (FEA) was conducted based on an anatomically detailed model, complying with the clinical protocol. Both the amounts of space closure and canine distalization of the vibration group were significantly higher than those of the control group, as measured intra-orally or on models (p<0.05). Therefore it is indicated that a 50Hz and 20g single-tooth vibration can accelerate maxillary canine retraction. The volume-average hydrostatic stress (VHS) in the periodontal ligament (PDL) was computationally calculated to be higher with vibration compared with the control group for maxillary teeth and for both linguo-buccal and mesial-distal directions. An increase in vibratory frequency further amplified the PDL response before reaching a local natural frequency. An amplification of PDL response was also shown to be induced by vibration based on computational simulation. The vibration-enhanced OTM can be described by mild, vigorous and diminishing zones among which the mild zone is considered to be clinically beneficial.