“Rapid” Orthodontics.. Is There Such A Thing.. Yet?

by Shadi Samawi

“I’m in no hurry: the sun and the moon aren’t, either. Nobody goes faster than the legs they have. If where I want to go is far away, I’m not there in an instant.”
Alberto Caeiro, The Collected Poems of Alberto Caeiro

In certain orthodontic marketing circles, the answer would be: Well, Of course there is!

© Shadi Samawi

© Shadi Samawi

However, as always, what we are really concerned with is scientific evidence rather than pure marketing talk. In this post, I would like to highlight some of the biological factors and limitations that are known to exist and this should make us think twice before flatly accepting such claims of faster tooth movement.

An increasing number of adult patients are seeking orthodontic treatment and requesting short treatments. A number of surgical techniques have been developed to accelerate orthodontic tooth movement in animals, however, these are mostly invasive procedures that can have minimal clinical application in day-to-day orthodontic practice. Others have used less invasive means such as piezoelectric incisions and selective tunneling in an attempt to research a more clinically-applicable method of accelerating orthodontic tooth movement. Self-ligating bracket designs have been shown to provide less friction to bracket sliding against archwires, thus reducing the forces required to move teeth. Technically, this should result in faster tooth moment due to less interference with sliding. However, even with a theoretical zero-friction appliance, there is a biological limitation to the rate of tooth movement that has been extensively researched; this limitation is what the latest new techniques of accelerated tooth movement claim to affect;  they imply having an effect on the cellular activity around tooth roots during orthodontic force application, leading to biologically faster tooth movement.

More recently, claims of accelerated tooth movement using mechanical vibrations have surfaced onto the marketing scene but with sparse research into that particular area. Although it is tempting to assume that such non-invasive methods can be used with no probable harm to the patient, it is still too early to clearly judge the effectiveness of such methods, let alone any possible side-effects that may occur, so caution is always advised. As per current scientific knowledge, the long-standing research findings of the biologically-acceptable rate of tooth movement in the range of 1-1.5 mm per month, still stand.

A message published by the Royal College of Surgeons of Edinburgh has warned about such claims of “rapid” orthodontic treatments that can be completed within six months or less, that are – as yet – unsubstantiated through clear scientific evidence and for which long-term studies regarding their side effects and stability are still absent. Until more extensive and clear clinical trials have been published, such claims can only be branded as “marketing hype” and as such, it would be better to avoid falling for that trap too early  and simply keep an open eye for solid new research to emerge before jumping onto the bandwagon.