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ment, as well as on cytokine activ- ity related to osteoblast and osteo- clast differentiation (specifically IL-1b levels in GCF). The patients ap- plied vibration to the experimental canine using a commercially avail- able electric toothbrush operating at high frequency (125 Hz). This studyfoundsignificantlyincreased tooth movement (~+61 per cent) ac- companied by a threefold increase in average IL-1b levels.18 It can be hypothesised that vibration, amplifies the familiar osteoblast–osteoclast cellular re- sponse causing bone formation and resorption, when the teeth are under force (i.e. from fixed appli- ances and aligners). In the absence of force, vibration causes new bone apposition only, which has poten- tial implications for the retention phase (see below). Note that the frequency of the device creating the accelerated tooth movement in the Leethanakul study was in that high frequency range shown to have superior effects on alveo- lar bone formation by Judex and Rubin, and Alikani et al.13,14 Enhanced retention Vibration therapy warrants the attention of the scientific commu- nity to further explore its effect during the orthodontic retention phase. Scientific literature docu- ments that the primary reason for orthodontic relapse is the inability of collagen fibres (Transseptal fi- bres and PDL) to reorganise quickly after the completion of orthodon- tic treatment and the delay in new bone apposition.19 Studies suggest that vibration can have potentially favourable impacts on both bone formation and reorganisation of the PDL fibres. A study from Rubin et al (re- ferred above) states that vibration therapy by itself has always been anabolic, which means it led to bone apposition and a decrease in bone resorption. Reports have documented an increase in bone density, bone formation, Type-1 collagen and non-collagenous ma- trixproteinexpressioninresponse to the therapy.14 Recent studies by Yadav et al. (2015) and Alikhani (2012) (both re- ferred above), have demonstrated that vibration therapy improved not only bone density, but also re- stored the integrity and thickness of the collagen fibres. With evi- dence suggesting that vibration therapy positively impacts both bone morphology and the PDL fi- bres, vibration during the retention phase may play a significant role in preventing orthodontic relapse. Conclusions The current debate over vibra- tion therapy and its impact on ac- celerated orthodontic tooth move- ment,shouldconsiderotherpoten- tial benefits of this therapy includ- ingapplicationsforalignerseating, relief of normal orthodontic pain, enhanced retention and applica- tions to implant dentistry and prosthodontics. It can be hypothesised that a vibration device operating in the high frequency range would likely be most effective in creating OTM as well as offering shorter wear times impacting compliance. The most commonly available commer- cial device operates at a frequency that is below thresholds having statistical significance in creating orthodontic tooth movement as documented in several recent stud- ies, and requires a relatively long, 20 minutes daily wear time. The strong supporting data concerning the positive effects of vibration therapy on bone forma- tion, bone density and collagen fibre reorganisation leads us to be- lieve that this modality of treat- ment may revolutionise the con- cept of orthodontic retention. The effects of high frequency vibration therapy may be useful in modifying the bone density to the clinician’s advantage in im- plant placement or to maintain the thickness of bone trabeculae in edentulous patients undergoing prosthodontic treatment. Editorial note: A complete list of refer- ences is available from the publisher. 23 Ortho Tribune United Kingdom Edition | 1/2017 ORTHO TRENDS Dr Amit Lala, DDS, PhD, earned his Master’s De- gree in Oral Bi- ology from the University of Ca- lifornia in Los Angeles. He then earned his DDS and PhD in Oral Biol- ogy from SUNY Buffalo, NY. He also completed his postgraduate residen- cy in Orthodontics at SUNY, Buffalo, NY. Dr Lala is affiliated with Harvard School of Dental Medicine as a lec- turer in the fields of Orthodontics and Oral Biology. practice management Short-term gains… long-term problems? trends & applications Vibration therapy in orthodontics: Realising the benefits industry report From straightforward to complex cases 12016 issn 1868-3207 Vol. 1 • Issue 1/2016 ortho international magazine of orthodontics International Magazines ortho international magazine of orthodontics Shipping Address Name Address Zip Code, City Country E-mail Date, Signature PayPal Credit Card Credit Card Number Expiration Date Security Code F +49 341 48474 173 subscriptions@dental-tribune.com EUR 22 per year (2 issues per year; incl. shipping and VAT for customers in Germany) and EUR 23 per year (2 issues per year; incl. shipping for customers outside Germany). 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