Dubravko Pavlin, D.M.D., Ph.D., associate professor of orthodontics interview

Dubravko Pavlin, D.M.D., Ph.D., associate professor of orthodontics at the University of Texas Health Science Center in San Antonio, Texas, talks about a study looking at a new device designed to shorten the length of time a patient has to wear braces.

When you put braces on your patients, what is the first thing they say to you?

Dr. Dubravko Pavlin: The patient always wants to know how long it is going to take, and during the treatment, 'When are the braces coming off - how much longer?'

What is the new device designed to do?

Dr. Pavlin: With the Acceledent, the idea is that we will shorten the orthodontic treatment. It is an idea that's been in use for a long time in orthopedics and recently in the treatment of osteoporosis. The vibrations, when they are applied to the bone, there is a solid body of evidence from clinical trials and from experiments in humans and animals that the bone metabolism accelerates – bone remodels at a faster rate. When we move the teeth, if bone remodels faster, the treatment will be shorter and the teeth will move faster through the bone. That idea and that concept was taken from osteoporosis treatment and other fields of orthopedics into orthodontics. We are applying it for the first time towards orthodontic patients to see if we can accelerate the
movement of the tooth through the bone by accelerating the remodeling of the bone surrounding the tooth.

Have there been many studies anywhere else where they're looking at this device that would determine whether it might work?

Dr. Pavlin: No, actually there is only one pilot study at the University of Texas in Houston. This is the first clinical trial of a larger scale that we're conducting here in San Antonio.

What are you actually doing with these patients, and how are you incorporating this in their treatment?

Dr. Pavlin: The treatment is a conventional, standard procedure like any other orthodontic treatment. Fixed braces are put in patients; the patient uses the Acceledent for about 20 minutes a day which causes vibration. It's a combination of vibratory forces applied on the teeth. The patient bites onto that plate, it vibrates, and that just once a day is expected to facilitate and accelerate the tooth movement.

How much difference do you think this is going to make in the time that a patient has braces on?

Dr. Pavlin: That is the big question that we're trying to answer in this study. The hope is that it would be at least 30 percent, but I expect more than that. If we are talking about the average orthodontic treatment being maybe 24 to 26 months, that would mean that we could shorten that treatment to maybe between 12 and 16 months.

How big a deal would that be for patients?

Dr. Pavlin: That would be a great deal for patients and for orthodontics, as well.

When did the trial start and what are you seeing so far?

Dr. Pavlin: The trial started back in June. So far, we do not have any solid data that we can base any answers on yet. We do have expectations that the results would be as expected. We can tell that the patients tolerate the appliance very well. It's been worn regularly and we didn't see any major problems with wearing it, and that is encouraging, but we do not have data at this point that we can claim any results yet.

Are you seeing anything different as far as movement of teeth or anything else so far?

Dr. Pavlin: It is very hard to say. For the most part, the doctors who treat patients are blinded and do not necessarily know which patient is having the appliance that's supposed to produce an effect and which don't because it's a randomized trial. Some patients are in control groups and some are in active treatment groups.

How long is the trial?

Dr. Pavlin: The trial itself will end about the middle of orthodontic treatment. We will not go all the way through the end. We will measure the first and second stages of treatment where the most active tooth movement is taking place.

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