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Neurological mechanisms involved in orthodontic tooth movement: A contemporary review

Ruchi Sharma, Naveena Preethi, Amit Sidana


Tooth movement by orthodontic force application includes remodeling changes in dental and surrounding investing tissues, dental pulp, periodontal ligament, alveolar bone, and gingiva. These tissues, when exposed to varying degrees of magnitude, frequency, and duration of applied force, undergo various macroscopic and microscopic changes. Orthodontic tooth movement differs markedly from physiological dental drift or tooth eruption that is characterized by the abrupt creation of compression and tension regions in the periodontal ligament. Orthodontic tooth movement can occur rapidly or slowly, depending on the physical characteristics of the applied force, and the subsequent biological response of the periodontal ligament. These force-induced strains alter the periodontal ligament’s vascularity and blood flow, resulting in local synthesis and release of various keymolecules, such as neurotransmitters, cytokines, growth factors, colony-stimulating factors, and arachidonic acid metabolites. These molecules can evoke many cellular responses by various cell types in and around teeth, providing a favorable microenvironment for tissue deposition or resorption. Studies in the early 20th century mainly analyzed the histological changes in paradental tissues after tooth movement. Those studies showed extensive cellular activities in the mechanically stressed periodontal ligament involving fibroblasts, endothelial cells, osteoblasts, osteocytes, and endosteal cells. Current literature has a vast data on molecular responses to orthodontic force. Therefore, the focus of this review is on the in-depth analysis of neurological mechanisms involved in the causation of orthodontic tooth movement.


Inflammation; innervation; neurological; neural modulation; orthodontic toothmovement; pain

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