By Emma Yasinski

Orthodontic surgery may have just gotten less painful and more efficient, paving the way for providers to take on more patients.

Using unique nanoparticles, researchers at Technion – Israel Institute of Technology were able to limit pain and decrease recovery time of orthodontic surgery – in rats, at least.

Avi Schroeder, PhD, lead author of the study published in ACS Nano, is neither a dentist nor an orthodontist, but a drug delivery engineer. At Technion – Israel Institute of Technology, Dr. Schroeder is an assistant professor of chemical engineering.

Technion's Dr. Avi Schroeder
Technion's Dr. Avi Schroeder

Dr. Schroeder wondered how physicians might be able to take advantage of the body’s own healing mechanisms in surgical procedures. His team’s goal was to find a model wherein they could perform a simple surgery that allowed for measurements accurate enough to demonstrate the robustness of the technology. Oral surgery provided those benefits.

Sometimes when a patient requires braces, an orthodontist uses a scalpel to cut the fibers that connect the teeth to the underlying bone, allowing the orthodontist to move the teeth to the desired locations before applying braces. The surgeon must cut through outer tissues in order to reach these fibers.

Dr. Schroeder estimates that human patients who would normally require two years’ worth of orthodontic care will only require six to seven months with his technique.

Dr. Schroeder estimates that human patients who would normally require two years’ worth of orthodontic care will only require six to seven months with his technique.

“Looking at the way surgeries were being performed…I was totally shocked,” Dr. Schroeder told Incisor. “We create so much damage trying to reach the target site using a scalpel. And it just didn't make sense. Then I tried to think, how is it done in nature?”

Dr. Schroeder and his team developed a method to skip the scalpel and biologically target this tissue instead, sparing the rest of the oral tissue.

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Liposomes and Fibroblasts

They designed a drug delivery mechanism that would use liposomes – a spherical sac – to carry deactivated collagenase (enzymes) to the surgical site. When the liposomes reached the site, they’d release the collagenase into the tissue. Activated by calcium naturally found at the site, collagenase would loosen the fibers that kept the teeth in place. Lastly, once the researchers applied braces, fibroblasts would help naturally restore the collagen fibers to a strong and healthy state to hold the teeth in their new positions. No scalpel necessary.

The researchers tested the approach on rats. They separated the rats into five treatment groups, all of which received braces for 15 days, then were monitored for 45 days of recovery. Three test groups received either the liposomes with collagenase, collagenase by itself, or traditional oral surgery with a scalpel before the braces. Two control groups received braces only, or empty liposomes followed by braces. The team measured tooth displacement every three days.

Not only did the rats that received the liposome with collagenase recover more quickly and maintain straighter teeth after the surgery, but they lost less weight than the controls, implying that the new procedure caused less pain.

Orthodontic care would only require six to seven months.
Orthodontic care would only require six to seven months. (Stock photo)

Dr. Schroeder estimates that human patients who would normally require two years’ worth of orthodontic care will only require six to seven months with his technique. The technique provides “a huge benefit [to orthodontists,] because we're shortening the time it takes them to treat their patient, meaning that they'll have free time to treat new patients.”

 

From Teeth to Heart Surgery

Next, Dr. Schroeder’s team plans to test the technique in other areas of the body, in hopes of developing less invasive surgical methods for a wide variety of procedures, including cardiac surgery. He also believes dentists and physicians will discover additional uses for the technology on their own.

“[Dentists and doctors] are very, very creative, and when they see a new technology, many times they think of applications that we haven't thought of in the past,” he told Incisor. “It's another tool in their hands and I think they'll be able to use it for other indications in the oral space.”

Author: Contributing writer Emma Yasinski received her Master of Science (MS) in science and medical journalism from Boston University. Her articles have also appeared at TheAtlantic.com, Kaiser Health News, NPR Shots, and Genetic Engineering and Biotechnology News.

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The information contained in this, or any case study post in Incisor, should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 3250 Airport Way S, Suite 701 | Seattle, WA 98134. Please print a copy of this posting and include it with your question or request.
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