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3 supporting bone produce variations in blood supply and the release of pro-inflammatory and inflammatory cytokines in the peri-radicular tissue. The downstream result of these changes is the recruitment of multinuclear giant cells, osteoblasts, osteoclasts and fibroblasts to produce OTM (Graber et al., 2012; Proffit et al., 2007; Meikle et al., 2006; Zengo et al., 1973). During OTM, the degree and duration of PDL and bone compression also affect the process of bone remodelling and therefore the rate of tooth movement. Undermining (indirect) resorption occurs on the compression side of a tooth when a relatively high amount of force produces a limited degree of PDL cell necrosis and an osteogenic stimulus. The result is an osteogenic response of alveolar bone remodelling from the alveolar bone side of the PDL, a process that is associated with reduced OTM rate. In comparison, frontal (direct) resorption describes the remodelling process that occurs when lighter forces (eg. 50-150g) stimulate bone resorption from the periodontal ligament side of the periodontal apparatus without cellular necrosis and therefore a relatively faster rate of OTM (Proffit et al 2007; Masella and Meister, 2006; Meikle et al., 2006). More recently, researchers have described the mechanisms by which forces applied to a tooth affect metabolic changes at the cellular levels. Forces applied to teeth result in cell membrane distortions and changes in tension-dependent cellular integrity (Tensigrity) (Krishnan and Davidovitch, 2009). Tensigrity describes pre-existing intracellular tensile stress derived from microfilaments, microtubules and intermediate filaments that convey a physical link between the nucleus and cell-surface adhesion receptors. When forces are experienced at the PDL and bone level, they are transferred to the cell and cause cell matrix distortions that alter transmembrane proteins, integrins, focal adhesions and cell gene expression to influence intracellular protein cascade events that affect cellular metabolism, cytokine and protein production such as TNFα, IL-1 and 6, PGE2, Substance-P, MMPs 8 and 13, BMP, TIMPs andPDF Image | Effect of LED Phototherapy on the Rate of Orthodontic Tooth Movement
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