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Med Oral Patol Oral Cir Bucal. 2013 Jan 1;18 (1):e146-50. Contraceptives and tooth movement

previously mentioned studies which show reduction in 5. Vescovi JD, VanHeest JL, De Souza MJ. Short-term response of
bone remodeling after oral contraceptive consumption. bone turnover to low-dose oral contraceptives in exercising women
Osteoclasts are primarily observed two days after force with hypothalamic amenorrhea. Contraception. 2008;77:97-104.
6. Mirzakouchaki B, Firoozi F, Shahrbaf S. Effect of psychological
application. We noticed a significantly lower number of stress on orthodontic tooth movement in rats. Med Oral Patol Oral
osteoclasts two days after appliance insertion in the ex- Cir Bucal. 2011;16:e285-91.
perimental group. This decrease in osteoclast number 7. Yamashiro T, Takano-Yamamoto T. Influences of ovariectomy on
may be due to one week administration of oral contra- experimental tooth movement in the rat. J Dent Res. 2001;80:1858-61.
8. Bridges T, King G, Mohammed A. The effect of age on tooth
ceptive prior to appliance insertion. It has been suggest- movement and mineral density in the alveolar tissues of the rat. Am
ed that maximum osteoclast recruitment happens five J OrthodDentofacialOrthop. 1988; 93:245-50.
to seven days after force application (13). In the present 9. King GJ, Keeling SD, Wronski TJ. Histomorphometric study
study osteoclast recruitment was significantly lower of alveolar bone turnover in orthodontic tooth movement. Bone.
1991;12:401-9.
seven days after force application and also during the 10. Farish E, Hart DM, Gray CE, Beastall G, Fletcher CD, Lindsay
linear phase after fourteen days. These findings show a R. Effects of treatment with oestradiol/levonorgestrel on bone, lipo-
reduced rate of bone remodeling at the movement side, proteins and hormone status in postmenopausal women. ClinEndo-
after administration of ethinyl estradiol/norgestrel. crinolOxf. 1989;31:607-15.
11. Milner M, Harrison RF, Gilligan E, Kelly A. Bone density chang-
Estrogen inhibits bone remodeling by concurrently es during two years treatment with tibolone or conjugated estrogens
suppressing osteoblastogenesis and osteoclastogenesis and norgestrel, compared with untreated controls in postmenopausal
from marrow precursors. Estrogen inhibits bone re- women.Menopause. 2000;7:327-33.
sorption via effects on the RANKL/RANK/osteopro- 12. Sultana S, Choudhury S, Choudhury SA. Serum alkaline phos-
phatase and bone mineral density: to assess bone loss in oral contra-
tegerin system, as well as by reducing the production ceptive pill user.Mymensingh Med J. 2002;11:107-9.
of a number of pro-resorptive cytokines (such as IL-1, 13. Taweechaisupapong S, Srisuk N, Nimitpornsuko C, Vattraphoudes
IL-6), along with direct effects on osteoclast activity T, Rattanayatikul C, Godfrey K. Evening primrose oil effects on os-
and lifespan (14). Relatively little is known about the ef- teoclast during tooth movement. Angle Orthod. 2005;75:356-61.
14. Syed F, Khosla S. Mechanisms of sex steroid effects on bone.
fects of progestins on bone metabolism. In the ovariec- BiochemBiophys Res Commun. 2005;328:688-96.
tomised rat model,progesterone was reported to have 15. BarengoltsEI,Gajardo HF, Rosol TJ, D’Anza JJ, Pena M, Botsis J,
similar effects to estrogenin one study (15), but antago- et al. Effects of progesterone on post-ovariectomy bone loss in aged
nistic actions in another (2). In a review by Thijssen, rats. J Bone Miner Res. 1990;5:1143-7.
16. Thijssen JH. Overview on the effects of progestins on bone. Ma-
it has been concluded that there are no indications that turitas. 2003;46:77-87.
the various progestins, used in clinical practice, have
either a bone-protective or an estrogen antagonistic ac-
tivity (16). Progestins do not add or subtract much of the
protective action of estrogens on the bones (16). Dur-
ing experimental tooth movement in the present study,
ethinyl estradiol/norgestrel resulted in a significant de-
crease in the number of osteoclasts. In our opinion this
effect is mostly because of the estrogenic component;
ethinyl estradiol.

Conclusion
In the present study it was observed that administration
of ethynil estradiol/norgestrel in Wistar rats significant-
ly reduced orthodontic stooth movement, 14 days after
appliance insertion, and osteoclasts at the movement
side. Therefore, female patients should be informed that
oral contraceptives may reduce their orthodontic tooth
movement and subsequently increase treatment period.

References
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4. Fisher W, Boroditsky R, Morris B, The 2002 Canadian Contracep-
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