Effects of infliximab local injection on orthodontic tooth movement in diabetic rabbits: A histological study

  • Anees M. Mudhir Department of orthodontic, College of Dentistry, Duhouk University, Duhouk, Iraq.
  • Rafah M. Al-Maroof Department of oral diagnosis, College of Dentistry, Hawler Medical University, Erbil, Iraq.
  • Fadhil Y. Jasim Department of orthodontic, College of Dentistry, Mosul University, Mosul, Iraq.
Keywords: Infliximab, Orthodontic movement, Diabetes Mellitus


Background and objective: Orthodontic tooth movement is mediated by tumor necrosis factor –α through activation of osteoclasts. Type 1 diabetes mellitus is characterized by a change in the bone remodeling and affects orthodontic treatment. This study aimed to investigate the effects of infliximab local injection on orthodontic movement in the diabetic rabbit.   

Methods: Sixty six rabbits were divided equally into three groups; two groups were rendered diabetic using alloxan injection, while the third group was regarded as a normoglycemic group. Only one of the diabetic groups received insulin treatment. All rabbits were subjected to orthodontic tooth movement of upper central incisor for 18 days, half of each group received infliximab subperiosteal injection, while the remaining number received saline injection. After sacrifice, tissue samples were subjected to histological preparation and histomorphometric analysis.   

Results: Insulin treated group revealed less prominent destruction of the periodontium when compared with the untreated group. The histological pictures of infliximab injected groups demonstrated less bone resorption in pressure side and more bone formation in tension side. There was a significantly smaller number of osteoclast with less compression in the width of the periodontal ligament in the tension side with infliximab injection. 

Conclusion: Infliximab local injection hindered bone resorption in the diabetic state during orthodontic tooth movement.  


Retzepi M, Lewis MP, Donos N. Effect of diabetes and metabolic control on de novo bone formation following guided bone regeneration. Clin Oral Implants Res 2010; 21:71-9.

Li X, Zhang L, Wang N, Feng X, Bi L. Periodontal ligament remodeling and alveolar bone resorptionduring orthodontic tooth movement in rats with diabetes. Diabetes Technol Ther 2010; 12:65-73.

Braga SM, Taddei SR, Andrade IJ, Queiroz- Junior CM, Garlet GP, Repeke CE, et al. Effect of diabetes on orthodontic tooth movement in a mouse model. Eur J Oral Sci 2011; 119:7-14.

Engebretson SP, Hey-Hadavi J, Ehrhardt FJ, Hsu D, Celenti RS, Grbic JT, et al. Gingival crevicular fluid levels of interleukin-1beta and glycemic control in patients with chronic periodontitis and type 2 diabetes. J Periodontol 2004; 75:1203-8.

VanDoornum S, McColl G, Wicks IP. Tumour necrosis factor antagonists improve disease activity but not arterial stiffness in rheumatoid arthritis. Rheumatology (Oxford) 2005; 44: 1428-32.

Gonzalez-Gay MA, De Matias JM, Gonzalez-Juanatey C, Garcia-Porrua C, Sanchez-Andrade A, Martin J, et al. Anti-tumor necrosis factor-alpha blockade improves insulin resistance in patients with rheumatoid arthritis. Clin Exp Rheumatol 2006; 24:83-6.

Yoshimatsu M, Shibata Y, Kitaura H, Chang X, Moriishi T, Hashimoto F, et al. Experimental model of tooth movement by orthodontic force in mice and its application to tumor necrosis factor receptor- deficient mice. J Bone Min Metab2006; 24:20-7.

Korczowska I, Lacki JK, Hrycaj P. Influence of infliximab on cytokines network and markers of bone remodeling in rheumatoid arthritis patients. Yonsei Med J 2013; 54:183-8.

Andrade I, Silva TA, Silva GA, Teixeira AL, Teixeira MM. The role of tumor necrosis factor receptor type 1 in orthodontic tooth movement. J Dent Res 2007; 86:1089-94.

Ibrahim RS. Effect of low energy laser irradiation on bone healing around intra osseous titanium implant in experimentally diabetic rabbits. PhD thesis in Oral histology and biology. University of Baghdad. College of Dentistry; 2003.

Seneschal J, Lepreux S, Bouyssou-Gauthier ML, Heliot-Hosten I, Economu A, Dehais J, et al. Psoriasiform drug eruptions under anti-TNF treatment of arthritis are not true psoriasis. Acta Derm Venereol 2007; 87:77-80.

Southerland JH, Taylor GW, Offenbacher S. Diabetes and periodontal infection: making the Connection. Clin Diabetes 2005; 23:171-8.

Bletsa A, Berggreen E, Brudvik P. Interleukin-1α and tumor necrosis factor-α expression during the early phases of orthodontic tooth movement in rats. Eur J Oral Sci 2006; 114:423-9.

SeonBaik H, Kwan-Kim CH, Lim W, Chun Y. Interleukin-1α and tumor necrosis factor-α expression on the compressed side of gingiva during orthodontic tooth movement. OJST 2012; 2:182-7.

Kaya FA, Hamamci N, Basaran G, Dogru M, Yildirim TT. TNF-α, IL-1β and IL-8 levels in tooth early leveling movement orthodontic tratment. J Int Dent Med Res 2010; 3:116-21.

Liu R, Bal HS, Desta T, Behl Y, Graves DT. Tumor necrosis factor-α mediates diabetes-enhanced apoptosis of matrix-producing cells and impairs diabetic healing. Am J Pathol 2006; 168:757-64.

Tawfiq FF. The effect of tumor necrosis factor-α inhibitor on the wound healing of oral mucosa in induced diabetic rats. M. Sc. thesis in Oral histology. Hawler Medical University; 2011.

Xie R, Kuijpers-Jagtman AM, Maltha JC. Osteoclast differentiation and recruitment during early stages of experimental tooth movement in rats. Eur J Oral Sci 2009; 117:43-50.

Kim HS, Park JW, Yeo SI, Choi BJ, Suh JY. Effect of high glucose on cellular activity of periodontal ligament cells invitro. Diabetes Res Clin Pract 2006; 74:41-7.

Graber LW, Vanarsdall Jr, R, Vig KW. Orthodontics current principles and techniques. 5th ed. Philadelphia: Elsevier Mosby; 2012.

How to Cite
Mudhir, A., Al-Maroof, R., & Jasim, F. (2018). Effects of infliximab local injection on orthodontic tooth movement in diabetic rabbits: A histological study. Zanco Journal of Medical Sciences (Zanco J Med Sci), 20(2), 1337 - 1348. https://doi.org/10.15218/zjms.2016.0029
Original Articles